What To Expect During Therapy for Schizophrenia

Reviewed by Laura Angers, LPC

Published 12/14/2020

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Schizophrenia is a mental health disorder that causes delusions and hallucinations (auditory, visual, tactile, or olfactory). The mental illness impairs the person’s thoughts, emotions, interactions, and decision-making skills. Since the delusions and hallucinations represent their reality, someone with untreated reality may find it difficult to differentiate between reality and the false reality presented by their brain.

Schizophrenia is highly disabling and affects millions of Americans. Contrary to popular opinion, the condition is completely unrelated to split personality. The disorder comes with positive and negative symptoms. Someone experiencing active, positive symptoms might exhibit responses visible to the people around them, such as agitation and disorganization. Negative symptoms are evident in a notable reduction in social interactions, motivation, and communication linked to cognitive impairment, including how the person processes and retrieves information. Positive symptoms can be inconsistent over time, and negative symptoms are often more chronic and persistent. Antipsychotic medications are usually effective for improving positive symptoms remarkably but may not be effective for negative symptoms.

The positive and negative symptoms make it hard for someone with schizophrenia to sustain relationships, work effectively, and engage in social interactions. Cost factors can inhibit getting proper treatment, and the disordered thinking that comes with the disorder often makes it challenging for the person to know that their thought patterns are stranger and adhere to treatment recommendations. Sometimes, people with schizophrenia indulge in substance abuse. Substance dependence in such patients can make effective treatment even more challenging.

Traditional schizophrenia treatment usually entails high doses of antipsychotic medications, which are effective but can come with unwanted side effects such as weight gain, emotional disconnect, and fatigue. Therefore, many people stop using their medications within the first year. More and more people are turning to therapy for schizophrenia. With medications, many people with schizophrenia will find the different types of psychotherapy and social support beneficial.

Types Of Therapy For Schizophrenia Treatment

Although psychotherapeutic techniques are beneficial for managing the symptoms of schizophrenia that persist despite medication, it is necessary to note that different forms of therapy exist for treating schizophrenia. They include:

INDIVIDUAL PSYCHOTHERAPY

Individual psychotherapy involves meeting with the mental health professional such as a psychiatrist or psychologist regularly for talk sessions. The sessions, which are effective if held regularly, may include discussing the present or past issues, thoughts, experiences, feelings, or relationships. Sharing these experiences with a trained professional – giving someone else a perspective of their world – allows people with schizophrenia to slowly come to learn more about themselves and the disorder. They can also learn to differentiate between reality and the false, distorted world caused by the disorder.

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SELF-HELP GROUPS

Support groups allow patients and their families to feel more accepted and less isolated. Each person in the group provides emotional support, advice, and acceptance. Some groups also engage in advocacy efforts and strive to improve people living with mental disorders. By talking to other people with schizophrenia about your symptoms and joining conversations about mental disorder aids, you can view your issues from other people’s experiences – perhaps even learning more and gaining a better perspective of the condition.

Also, self-help in other aspects is crucial. Practicing self-help techniques such as relieving stress, seeking support, and changing diet may not appear as an effective strategy against a major disorder like schizophrenia. Still, they can have a remarkable effect on the frequency and severity of symptoms, as well as boost your mood and self-esteem.

SOCIAL SKILLS TRAINING (SST)

This training utilizes behavior therapy ideas to help patients learn skills like communication, assertiveness, and others related to managing the condition and living independently. The skills are divided into multiple distinct steps. Social skills training usually occurs in small groups, supervised by two therapists. After describing the steps, the therapist will exemplify the skills through role-playing. Participants then use it to learn and practice their skills. Therapists and members of the group give helpful feedback to the person after every role-play, and each person gets the chance to practice the skill a couple of times. Constant practice and overlearning the skills are critical parts of social skills training.

PSYCHOSOCIAL THERAPY

Psychosocial rehab targets social and vocational lessons. These lessons teach people the skills required to interact with others, integrating with the community, getting hired, and keeping a job. For instance, they might learn about job applications, financial planning, using public transportation, and keeping up with appointments.

COGNITIVE BEHAVIOR THERAPY (CBT)

In CBT, a psychotherapist helps people with schizophrenia learn to change potentially harmful thoughts and actions that may contribute to negative emotions, even if they started as early as childhood or teenage years. Cognitive-behavioral therapy is classified into two major aspects – the cognitive part, which helps people change their negative thought patterns about a situation into healthier and more positive thoughts, and the behavioral part, where patients learn to change their reactions.

CBT is a short-term, problem-oriented approach that aims to help people with schizophrenia learn coping skills to manage challenging situations. The therapy anchors itself on setting goals, accomplishing them, and getting a form of self-awareness and confidence to continue and succeed in therapy.

Cognitive-behavioral therapy is usually provided for one hour per week over 12 to 16 weeks. During the CBT sessions, the therapist will work with the patient to help them realize how their feelings, thoughts, and behaviors affect each other. The therapist teaches methods of changing negative thoughts and reacting to them differently to remove undesirable feelings and difficult behavior. The person will also learn how to assess the reality of their thoughts and perception, ignore any voices, and cope with symptoms.

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CBT can also help those living with schizophrenia develop better social and problem-solving skills, reduce symptoms’ severity, and reduce the risk of relapse – the time when the symptoms reappear. CBT has been proven effective for many mental health illnesses. Another benefit of CBT is using a practical approach to modify inaccurate or impaired thoughts and emotions by enabling a careful comparison of those thoughts with recognizable facts. For instance, if the person believes they are idle, a CBT method would motivate the person to fill a diary of daily tasks. The therapist would check the diary later with the patient, and they will compare the facts with perceptions. Patients would be assigned tasks involving techniques to increase productive activities.

Studies have shown that this type of talk therapy can work for the most challenging symptoms of schizophrenia. Although more studies are required, CBT methods may help teach the brain, and the learning may cause rewiring in the brain to adjust or circumvent the brain circuits that are functioning incorrectly due to the underlying condition. A major feature of CBT may focus on redirecting attention from automatic and non-productive negative beliefs to more practical and fitting thought patterns and behavior. Practically, this may be a type of cognitive rehabilitation that helps correct impairments in attention and functional memory.

Implementing multiple different treatment techniques together can be addictive. Some studies have shown that using CBT with pharmacotherapy (medications) can provide significant improvement over applying treatment only. The goal is always to combine treatments based on clinical evidence. Combining evidence-based talk therapies with evidence-based medication treatment will produce better and lasting results.

An advantage of evidenced-based psychotherapies like CBT is that they can be handled by trained professionals who are not physicians. A team approach is generally advisable, and therapists must use the latest psychotherapies.

FAMILY THERAPY

Family members and spouses have a major role to play in the treatment of people with schizophrenia. Schizophrenia can be quite challenging, and close relatives and friends have to take more responsibility and make necessary adjustments to manage the disorder and support the patient.

Undergoing family therapy can be an important experience for everybody since it gives all family members and spouses a chance to talk and understand each other’s emotions, actions, and thoughts. With open dialogue comes a better understanding and appreciation for each other. This can help relationships and allow people to find ways to support one another to make life a lot easier for those involved.

Schizophrenia can affect the entire family in different ways. For those with schizophrenia, their interactions and environment can significantly affect the symptoms’ extent and, eventually, their recovery. Expressing strong emotions such as yelling, screaming, fighting, and hostility in a family setting can worsen the disorder’s effect, which can usher in more psychotic episodes. There is a chance that schizophrenia symptoms increase stress within the household, causing more tension and high emotions, or other causes of conflict.

Children may be too young to fully comprehend mental illnesses such as schizophrenia and their impact on the family. They may blame themselves or separate themselves from others if a family member has schizophrenia. Family members who sacrifice their jobs or hobbies to help manage the condition can often suffer from personal well-being. With family therapy, people can start to relieve and reduce some of the challenges that result from the disorder.

Family therapy for schizophrenia usually involves stress education, learning, emotional processing, and regulating, together with planned problem-solving. The group will work collaboratively to improve their understanding of the condition and management options. This helps to encourage empathy and affective support, which also helps to correct any unacceptable communication patterns.

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Connecting with the family: If the person living with schizophrenia gets hospitalized, their family will assist the therapist and provide all required information. During the sessions, they will also discuss with the doctor the appropriate long-term intervention for the patient and the family therapy sessions’ modalities.

Sharing and learning: The family will collaborate to know more about the condition and what is necessary to minimize the symptoms. If the person with schizophrenia has particular needs, they can talk about it during the session. The family will talk about requirements, evaluate a list of potential support or solutions, and conclude the detailed plan to assist them.

Collaborative effort: During the appointment, there is a focus on patients slowly accepting responsibility. The patient may receive tasks that could be challenging at first but get easier to accomplish.

Families will work, participate, and learn how to support the person in this stage and prevent situations that may worsen their symptoms or trigger psychotic experiences. During family therapy, the goal is to encourage loved ones to assist each other. The therapist will work with the patient and their close relatives, promoting a mutual acceptance of the mental health disorder and enabling healthy dialogues that cover family dynamics and relationships

By sharing information, families can learn about schizophrenia and its impact on their loved ones. It is common to see families leave therapy sessions feeling reinvigorated as they learn new methods to assist their relatives on their path to recovery.

In Conclusion

Right now, there is no known cure for schizophrenia, but it is possible to treat and manage the condition successfully – both with medications and therapy. The point is to have a solid support system and obtain the proper treatment for your needs.

Knowing that taking the first step and admitting you need help is often the most challenging. Often, people dealing with schizophrenia do not know or feel like something is wrong – they do not see their thoughts or actions as strange or beyond the norm. Some may be scared of the stigma or negative labeling that may follow after seeking medical assistance.

It is often beneficial for many people to start the process by visiting a mental health specialist. These professionals receive training to detect schizophrenia symptoms and make an accurate diagnosis, ruling out possible conditions that may also contribute to the symptoms. You can start by taking a schizophrenia assessment test.