Psychotherapy for Schizophrenia

Psychotherapy for schizophrenia has an important role in the treatment of schizophrenia. There are various reasons for this.

Although medications are the mainstay of treatment, the cure rates for schizophrenia are low, and a significant majority continue to suffer relapses and chronic residual symptoms. Reasons for this include poor response to medication, poor compliance due to side effects and poor insight into their illness. This has necessitated the need for adjunctive forms of treatment to medications.

The cause of schizophrenia is seen to lie within a bio-psycho-social model with influences between psychological, social and genetic factors which result in an individual being vulnerable to the development of psychosis. The patient's psychological make-up will continue to influence how the disease affects the individual.

Schizophrenia is a chronic lifelong illness which can have a negative effect on most aspects of patients' lives, including relationships with family and friends, occupational and life opportunities, self image and self esteem. There is an increased incidence of comorbid disorders such as depressive and anxiety disorders. Patients have to come to terms with a lot: stigma, social exclusion, cognitive problems, acceptance of having an illness, and acceptance of the need to take medication, possibly lifelong. There is an extreme amount of loss, anger and denial which has to be processed.

In addition to the patient, there is also the family and loved ones that are affected and who have to learn to live and deal with the consequences.

These are aspects of the illness which cannot be treated with medications, and psychotherapy for schizophrenia(talking therapy) has an important role to play in the treatment.

Having access to psychological treatment or psychotherapy is in itself not enough. For any form of therapy to be effective, there has to be a therapeutic relationship between the patient and therapist/psychologist. This has to a honest and genuine, empatheitc, trusting, non-judgemental and respectful space where appropriate boundaries are maintained and most importantly where the patient feels heard.

Familes are often keen for their ill member to get therapy, but sometimes do not realise that there might be barriers to this. The patient has to be in the 'right space' and accepting of their need for psychotherapy, and be motivated and willing to enagage.

This may sound strange, but patients also have to be capable of forming a psychological relationship, and not everyone is capable of this for various reasons. This may be due to the disease itself and the negative symptoms and cognitive deficits.

The patient needs to be self reflective and be able to talk about themselves and their feelings. And lets be honest, not everyone is able or happy to do this.

I'll discuss some types of psychological treatments which are commonly available. These include: