1. Effective Treatment of Persons Diagnosed with Schizophrenia
Katie Halaburka, MSW Candidate
The Greater Rochester Collaborative Master of Social Work Program
Abstract
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Schizophrenia is a mental disorder that affects an individual’s ability to think clearly, function, and impedes ability to identify and respond to emotions. As well as the ability to interpret reality. Research suggests effective treatment with persons diagnosed with schizophrenia is that which is multifaceted with community support/family structure, medication management, and psychotherapy.
Schizophrenia Defined
Key Concepts
Effective Treatment
Schizophrenia is a mental disorder, that impacts the way 0.5 to 1.0 percent of people worldwide think, feel, and act and accounts for approximately two thirds of all psychotic disorders (Paiva et al., 2013). Schizophrenia is a chronic relapsing disorder resulting in shortened lifespan with significant impairments in social and vocational functioning (Tandon, Nasrallah, & Keshavan, 2010).
Positive Symptoms
Positive symptoms involve impaired, reality testing and include delusions, hallucinations, and other reality distortions (Tandon et al., 2009).
Negative Symptoms
Negative symptoms include loss of drive, blunted emotions, social withdrawal and lack of insight (Tsapakis, 2015).
Cognitive Impairments
Cognitive impairments are when an individual has difficulty with memory, learning new things, or making simple decisions that affect everyday life (Nuechterlein et al., 2011).
Community Support/Family Structure:
The community Support Program was a system wide reform movement in the 1970’s designed to address problems created by deinstitutionalization.
The goals of the movement were continuous community treatment, support services, assertive crisis, outreach services, and coordinated community care through case management.
Implementing community supports in areas such as independent living, employment, and education (Prince, 2005).
Research suggests family involvement has been seen as a casual factor in the illness. Family involvement is one of the psychosocial factors that affect the clinical course and outcome of schizophrenia including relapse (Pernice-Duca, 2010).
Medication Management:
Antipsychotic medication was introduced in the 1950’s and has become the most effective treatment for schizophrenia according to research (Van, 2016).
According to research medication management has been identified as a key concept of the recovery process in mental illness (White & Hardy, 2010).
For those diagnosed with schizophrenia medication treatment focuses on treating the chemical imbalances in the brain to decrease distressing symptoms and prevent future relapse (White & Hardy, 2010).
According to research typical antipsychotic drugs have been used to treat schizophrenia since the early 1950’s (White & Hardy, 2010).
Psychotherapy:
According to research in the last century psychotherapy has been a core treatment modality, whereas other times in history it virtually disappeared. (Hamm, Hasson-Ohayon, Kukla, & Lysaker, 2013).
According to research CBT for schizophrenia suggests that cognitive interventions might be used to normalize and modify maladaptive beliefs related to psychotic symptoms, as well as situating the beliefs on a continuum of normal mental life (Hamm et al., 2013).
Evidence suggests persons with schizophrenia accept CBT, and over a period of time have shown a decrease in dysfunctional cognitions, positive symptoms, and recidivism rates (Hamm et al., 2013).
Research suggest five integrative approaches by Gumley & Clark, Harder & Folke, Salvatore &colleagues, Pijenborg & colleagues and by Hasson-Ohayon. These five approaches draw upon different theoretical traditions and implement different techniques. These five approaches share interest in attachment and interpersonal connectedness, recognition of personal narrative, and emphasis on the role of metacognitive processes (Hamm et al., 2013).
Extent of the Problem
According to research the overall lifespan for schizophrenics is shortened by nine years or more, some being accounted for by a high rate of suicide during the first ten years of the disorder (Jobe & Harrow, 2010).
According to research the incidence of schizophrenia typically arises between the ages of ten and twenty-five for men and twenty-five and thirty for women (Rajji, Ismail, & Mulsant, 2009).
According to research schizophrenia is diagnosed more frequently among African Americans whereas mood disorders are diagnosed more often among Caucasians (Hafner, 2004).
The cutoff point for late onset schizophrenia has been put to forty years of age (Skokou & Gourzis, 2014).
According to research it was found that living in an urban environment during childhood and adolescence is associated with roughly two fold increases in schizophrenia incidence later in life (Haddad et al., 2014).
Fifty percent of schizophrenic patients, under normal treatment conditions, relapse within a year after their latest episode, resulting in spending fifteen to twenty percent of their time in psychiatric institutions (Ayuso-Gutiérrez & Vega (1997),
Contributing Factors
Cannabis Use
Obstetric complica-tions
Maternal factors
Environmental factors/stress
Genetics
Recommendations
Brain abnorma-lities
Although research supports effective treatment with persons diagnosed with schizophrenia in that which is multifaceted with community support/family structure, medication management, and psychotherapy they all have their own set of barriers an individual would need to hurtle. Although there were articles and information to support the above statement, I found that medication management is the most effective component in effective treatment with those suffering with schizophrenia. The use of Psychotherapy is evolving and plays a factor in an individual’s treatment for schizophrenia. I would like to see more statistics and studies of effective psychotherapy approaches that work for individuals with schizophrenia.
Community Support/Family Structure
Medication management
Psychotherapy
References available on separate handout
Onset Schizophrenia