Rehabilitation and Counseling for Schizophrenia Patients

By ending or reducing the painful hallucinations, delusions and thought disorders, antipsychotic medications allow a patient to gain benefit from rehabilitation and counseling aimed at promoting the individual's functioning in society. Social skills training, which can be provided in group, family or individual sessions, is a structured and educational approach to learning social relationship and independent living skills. By using behavioral learning techniques, such as coaching, modeling and positive reinforcement, skills trainers have been successful in overcoming the cognitive deficits that interfere with rehabilitation. Research studies show that social skills training improves social adjustment and equips patients with means of coping with stressors, thereby reducing relapse rates by up to 50 percent.

Another type of learning-based treatment that has been documented to reduce relapse rates is behaviorally oriented, psychoeducational family therapy. Mental health professionals recognize the important role families play in treatment and should maintain open lines of communication with the families as treatment evolves over time. Providing family members, including the patient, with a better understanding of schizophrenia and its treatment, while helping them to improve their communication and problem-solving skills, is becoming a standard practice in many psychiatric clinics and mental health centers. In one study, when psychoeducational family therapy and social skills training were combined, the relapse rate during the first year of treatment was zero.

Psychiatric management and supervision of regular medication use, social skills training, behavioral and psychoeducational family therapy, and vocational rehabilitation must be delivered within the context of a community support program. The key personnel in community support programs are clinical case managers who are experienced in linking the patient to needed services, assuring that social services as well as medical and psychiatric treatment is delivered, forming solid and supportive long-term helping relationships with the patient, and advocating for patients' needs when there is a crisis or problem.

When continuing treatment and supportive care is available in the community, with a partnership of family, patient and professional caregivers, patients can learn to control their symptoms, identify early warning signs of relapse, develop a relapse prevention plan, and succeed in vocational and social rehabilitation programs. For the vast majority of persons with schizophrenia, the future is bright with optimism--new and more effective medications are on the horizon, neuroscientists are learning more and more about the function of the brain and how it goes awry in schizophrenia, and psychosocial rehabilitation programs are increasingly successful in restoring functioning and quality of life.

For comprehensive information on schizophrenia, visit the HealthyPlace.com Thought Disorders Community.

Sources: 1. American Psychiatric Association, Schizophrenia pamphlet, last revised 1994. 2. NIMH, Schizophrenia Fact Sheet, last revised April 2008. 3. Merck Manual, Schizophrenia, Nov. 2005.

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