Post by Mel on Mar 15, 2006 11:32:32 GMT -5
Steven K. was 17 when he was diagnosed with schizophrenia. Thirty years later, with the help of the newest generation of antipsychotic drugs, the major symptoms of his disease are under control. But this doesn't mean he feels able to handle social interactions or work situations.
"He's missed out on a lot of life experience, a lot of invaluable life lessons," says Rita Seiden, director of Brooklyn's Park Slope Center, who has treated Steven for several years.
Her therapy, she explains, focuses on working out daily problems rather than achieving psychological insights. "We do a lot of specific problem solving," she says. "I try to teach them to accept themselves as they are and grow up."
She's not alone. There is increasing evidence that, along with antipsychotic medication, some forms of talk therapy should become part of the standard treatment for schizophrenia. A recent study and editorial in the November 1997 issue of the American Journal of Psychiatry make a strong case.
Led by University of Pittsburgh psychiatry professor, Gerard Hogarty, the study found that patients who underwent personal therapy – a form of psychotherapy specifically tailored to the needs of people with schizophrenia – were less likely to experience relapses or to be noncompliant in their treatment. Even better, their social adjustment skills continued to improve throughout the entire three-year study – in contrast to patients receiving other forms of talk therapy, who leveled off after the first year.
As developed by Hogarty and his team, personal therapy is a three-part process –
In the first phase – the months immediately after discharge – the therapist develops a rapport with the patient, and conducts some basic psychological education
In the intermediate phase, the patient learns a variety of ways to deal with stress, including improved social skills and relaxation exercises
Finally, in the advanced phase, the patient works to understand the relationship among stresses, poor social behavior, other people's reactions, and schizophrenia symptoms.
In an accompanying editorial, Wayne Fenton, medical director of Chestnut Lodge Hospital in Rockville, MD, calls for wider use of multidisciplinary approaches. "Today, we appreciate that no single treatment is definitive for schizophrenia," he writes. "And comprehensive care requires integrating a variety of perspectives."
Nevertheless, this approach faces challenges from managed care plans reluctant to refer patients to talk therapists or to pay for this form of treatment. And neither Medicaid, Medicare, nor most HMOs will pay for phone time with patients. "There's a lot of non-face-to-face time involved in doing therapy with people with schizophrenia," she says.
Beyond that, few healthcare providers are experienced in psychotherapy for people with schizophrenia. Understandable, says Seiden, since "...until two or three years ago, there was little expectation that people with schizophrenia would ever be able to function normally. Seeing people with schizophrenia recover is very new to us."
So where can people go for help? Seiden recommends getting referrals from psychiatrists experienced in prescribing the newest generation of antipsychotic medications – or from consumer organizations such as the National Alliance for the Mentally Ill and the National Mental Health Association.
"He's missed out on a lot of life experience, a lot of invaluable life lessons," says Rita Seiden, director of Brooklyn's Park Slope Center, who has treated Steven for several years.
Her therapy, she explains, focuses on working out daily problems rather than achieving psychological insights. "We do a lot of specific problem solving," she says. "I try to teach them to accept themselves as they are and grow up."
She's not alone. There is increasing evidence that, along with antipsychotic medication, some forms of talk therapy should become part of the standard treatment for schizophrenia. A recent study and editorial in the November 1997 issue of the American Journal of Psychiatry make a strong case.
Led by University of Pittsburgh psychiatry professor, Gerard Hogarty, the study found that patients who underwent personal therapy – a form of psychotherapy specifically tailored to the needs of people with schizophrenia – were less likely to experience relapses or to be noncompliant in their treatment. Even better, their social adjustment skills continued to improve throughout the entire three-year study – in contrast to patients receiving other forms of talk therapy, who leveled off after the first year.
As developed by Hogarty and his team, personal therapy is a three-part process –
In the first phase – the months immediately after discharge – the therapist develops a rapport with the patient, and conducts some basic psychological education
In the intermediate phase, the patient learns a variety of ways to deal with stress, including improved social skills and relaxation exercises
Finally, in the advanced phase, the patient works to understand the relationship among stresses, poor social behavior, other people's reactions, and schizophrenia symptoms.
In an accompanying editorial, Wayne Fenton, medical director of Chestnut Lodge Hospital in Rockville, MD, calls for wider use of multidisciplinary approaches. "Today, we appreciate that no single treatment is definitive for schizophrenia," he writes. "And comprehensive care requires integrating a variety of perspectives."
Nevertheless, this approach faces challenges from managed care plans reluctant to refer patients to talk therapists or to pay for this form of treatment. And neither Medicaid, Medicare, nor most HMOs will pay for phone time with patients. "There's a lot of non-face-to-face time involved in doing therapy with people with schizophrenia," she says.
Beyond that, few healthcare providers are experienced in psychotherapy for people with schizophrenia. Understandable, says Seiden, since "...until two or three years ago, there was little expectation that people with schizophrenia would ever be able to function normally. Seeing people with schizophrenia recover is very new to us."
So where can people go for help? Seiden recommends getting referrals from psychiatrists experienced in prescribing the newest generation of antipsychotic medications – or from consumer organizations such as the National Alliance for the Mentally Ill and the National Mental Health Association.