Abstract
During the past 20 years significant changes have occured in the way the treatment of schizophrenia is conceptualized. As hospitalizations have become shorter and more restricted, the treatment has shifted to outpatient setting and the community.
It is now clear, that combining pharmacologic treatment with psychosocial interventions offers beyond the power of any single approach. Meanwhile, it became clear that insight-oriented psychotherapy was ineffective in most patients with schizophrenia, but had the potential to worsen its symptoms.
Newer psychosocial treatment models have been developped that emphasize the practical resolution of common social and psychological difficulties in schizophrenic patients. Because social and interpersonal skills are generally deficient in schizophrenic patients, social skills training aims to help the patient develop more appropriate behaviour.
Research has shown that the social skills training can significantly enhance social functioning, but probably haslittle effect on risk of relapse. Models involving family therapy have received greater prominence.
They are especially important since they have a direct impact on relapse rate. Psycho-educational programs will improve cooperation and compliance of both patient and family.
Learning to minimize criticism and emotional overinvolvement will help to decrease the patient's level of stress, reducing the risk of relapse. Multiple-family groups may work even better than single-family interventions.
Cognitive rehabilitation is focused on improving information processing skills such as attention, memory, vigilance, and conceptual abilities. Cognitive therapy approaches arefocused on changing the chronic hallucinations and delusions.
Patients learn various coping strategies from distraction of reality to reality testing of thesepsychotic phenomena