Psychological and Schizophrenia Individuals Suffering

Psychological and Schizophrenia

Individuals suffering from schizophrenia are often dependent on the consumption of drugs, but they show little promise of improvement in terms of social adjustment and becoming employed, with the exception of clozapine. Unfortunately, even if people are responsive to their medications, they continue to exhibit disabling symptoms and social dysfunction, along with being at risk for relapse. The psychological aspect of this disease is to integrate people into society without the dependency on drugs, and being able to function socially. Therefore, it is vital to incorporate psychological treatments like family therapy, group, and individual therapy sessions.

Psychological interventions utilize behavioral, psychoeducational methods over traditional outpatient care. In a study led by Mueser, it was reported that schizophrenics whose course of treatment included family therapy, there was a relapse rate of about 25%. This percentage is compared to the 64% who received routine treatment sans therapy. Furthermore, such advantageous outcomes and impacts are sustained up to two years or longer. In another study led by Hogarty, it compared the effect of family and supportive therapy. In the former group, it included chronic patients who lived at home with their families. In the latter group, patients received such therapy on a biweekly basis with minimal medication dosage, and case management. The first group showed no beneficial advantage over the second because for the supportive therapy group, the relapse rate was 29% at three years. In studies led by Falloon, Leff, and Hogarty, they focused their attention on the decline of expressed emotion levels as an active mediator for the benefits of family therapy. As a result, patients who lived with families that had a low expressed emotion atmosphere experienced reduced relapse compared to those who dwelled in a high expressed emotion setting. In an investigation led by McFarlane, the study involved schizophrenics who were at a higher risk of experiencing relapse. It involved two groups; one half received a multifamily group treatment on a biweekly basis, while the other half attained family therapy but during times of need. In the end, there was no difference in relapse rates; both were 27% at two years.

Family therapy can also be categorized as two classifications; one is standard while the other is more intense. The relapse rate for the former is 40%-83% while for the latter, it is 14%-33%, but both levels of intervention were effective. The goal of the more aggressive family therapy is so patients aren't rehospitalized for relapse and can establish themselves in the community. Bustillo (2001) has reported "the most consistent effects have been a reduction of time spent in the hospital (demonstrated in 14 of 24 studies; nine reported no differences) and an improvement in housing stability (demonstrated in nine of 13 studies; four reported no differences). Only a minority of studies have found advantages in social adjustment (four of 16) or employment (three of nine, and these jobs represented mostly sheltered rather than competitive employment)."

A psychological aspect of schizophrenia involves the intervention of patients with the use of cognitive behavior therapy or CBT. Such treatment is used for those whose psychotic symptoms constantly occur despite consumption of medication. The objective of CBT is for schizophrenics who do not respond to their medication and to have their episodes of delusions and hallucinations or other distress to be decreased. As well, CBT's goal is to reduce the risk of relapse and social dysfunction. Bustillo (2001) noted such therapy centers on "rationally exploring the subjective nature of the psychotic symptoms, challenging the evidence for these, and subjecting such beliefs and experiences to reality testing."

In a study led by Kuipers, it was discovered that CBT schizophrenics demonstrated a significant decrease in their symptoms compared to standard treatment. In an investigation led by Tarrier, CBT has reduced incidences of patients' delusions and hallucinations compared to the results of supportive counseling and routine care. As a result, eleven out of thirty-three patients who received CBT reduced the aforementioned symptoms by 50%, and were maintained at the twelve-month follow-up. In Drury's study, CBT's effect with antipsychotic medicine on acutely psychotic inpatients recovered from their psychotic episodes more rapidly and complete. At their nine-month follow-up, 95% of CBT patients had minor or no incidences of hallucinations and delusions. However, those in the control group, 44% of schizophrenics experienced minimal aforementioned symptoms and episodes. In a study led by Buchkremer, it compared four types of interventions, two of which were CBT, to routine care. Such treatment was given over eight months, assessed after one year, and follow-up of two years. It was shown the group that received CBT with individual and family psychoeducational therapy experienced reduced hospitalizations.