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Schizophrenia

Treatments

 

Treatment Summary: Brief-cognitive behavioral therapy works requires a psychologist to accept that the cognitive distortions and disorganized thinking of a patient with schizophrenia. The distortions or disorganized thinking comes from biological problem that will not cease simply because the "correct" interpretation of reality is explained to the client. Brief cognitive therapy can only be successful if the psychologist accepts the client's perception of reality, and determines how to use the patient's miss-perceptions to assist the client in correctly managing life problems. The goal is to help the client use information from the world through friends, family and or the news to make adaptive coping decisions. The treatment goal, for the cognitive therapist is not to cure schizophrenia, but to improve the client's ability to manage life problems, to function independently, and to be free of extreme distress and other psychological symptoms

  • Reference: : Douglas Turkington, D. K. (2002). Effectiveness of brief-cognitive behavioral therapy intervention in treatment of schizophrenia. British Jornal of Psychiatary , 523-527.
  • Submitter: Shameek Gray-Jones

Pharmacotherapy

Treatment Summary: Treatment for Schizophrenia has depended on antipsychotic drugs such as clozapine and olanzapine. A new drug called aripiprazole has been used as an agonist which is a chemical that binds to a receptor of a cell and triggers a response by that cell, but its performance compared to olanzapine is still being researched. Chlorpromazine was discovered in the 1950's and began to be used on patients that had delusions and hallucinations. This medicine's objective was to target dopamine D2 receptors (Freedman, 2005). It improved the patient's delusions and hallucinations but created Parkinson like symptoms, some weight gain and was only effective in some of the patients. In the 70's clozapine began to be used hoping it would be more effective. It also did not result in movement disorders, but other problems arose, drastic weight gain, type 2 diabetes and cost of the drug (Freedman, 2005). Olanzapine and clozapine have been noted to be more effective than other drugs. There has also been an increase in cognitive function when these drugs are used. One major problem with olanzapine is massive weight gain. If this occurs, other treatment options need to be considered. These drugs do not provide the majority of the patients with a permanent treatment and are only partially effective, therefore, prognosis is poor.

  • Reference: Freedman, R. (2005). The choice of antipsychotic drugs for schizophrenia. The New England Journal of Medicine, 353(12), 1286-1288. Retrieved from http://www.nejm.org
  • Submitter: Dawn Robinson

Pharmacotherapy

Treatment Summary: Treatment for Schizophrenia has depended on antipsychotic drugs such as clozapine and olanzapine. A new drug called aripiprazole has been used as an agonist which is a chemical that binds to a receptor of a cell and triggers a response by that cell, but its performance compared to olanzapine is still being researched. Chlorpromazine was discovered in the 1950's and began to be used on patients that had delusions and hallucinations. This medicine's objective was to target dopamine D2 receptors (Freedman, 2005). It improved the patient's delusions and hallucinations but created Parkinson like symptoms, some weight gain and was only effective in some of the patients. In the 70's clozapine began to be used hoping it would be more effective. It also did not result in movement disorders, but other problems arose, drastic weight gain, type 2 diabetes and cost of the drug (Freedman, 2005). Olanzapine and clozapine have been noted to be more effective than other drugs. There has also been an increase in cognitive function when these drugs are used. One major problem with olanzapine is massive weight gain. If this occurs, other treatment options need to be considered. These drugs do not provide the majority of the patients with a permanent treatment and are only partially effective, therefore, prognosis is poor.

  • Reference: Freedman, R. (2005). The choice of antipsychotic drugs for schizophrenia. The New England Journal of Medicine, 353(12), 1286-1288. Retrieved from http://www.nejm.org
  • Submitter: Dawn Robinson

Pharmacotherapy, Cognitive Behavioral Therapy, Psychosocial

Treatment Summary: The mainstay treatment of Schizophrenia is pharmacotherapy particularly antipsychotics that block dopamine in the mesolimbic cortical region. These medications reduce if not eliminate hallucinations, aberrant thought processes such as paranoia. Following stabilization with antipsychotic medication (the acute phase), the client can be taught to differentiate aberrant sensory stimuli from realistic stimuli (the maintenance phase) . In addition residual symptoms can be managed by using cognitive approaches that teach the client to regard aberrant sensorium as a "symptom" that can be managed by reinforcing incompatible behaviors and thoughts. For example, clients can be taught to focus their attention on powerful sensorium such as music. Likewise clients can be taught to disregard diminished aberrant sensorium by building endurance in carrying out productive activities. Family therapy is used to develop an effective social support system that supports adherence to medication regimens, and participates in an effort to reduce stress. Stress reduction typically leads to symptom reduction and so the client can learn techniques to reduce stress. Psycho education reinforces stress reduction and discourages comorbid substance abuse that is associated with treatment failure and disintegration. Furthermore, clients are taught to address medication side-effects directly with their psychiatric provider rather then terminating therapy against medical advice. Family members can also be trained to identify signs of treatment failure and seek immediate professional intervention for their loved one. In summary, treatment includes pharmacological approaches, psycho education, and cognitive behavioral therapy to reduce psychotic and affective symptoms and reinforce healthy behaviors that are integrative.

  • Reference: We live with Schizophrenia (Septmber, 2014) Otuska American Pharmaceutical, Inc. doi: 09US14EUC0001
  • Submitter: N/A

Multiple Family Group Psychoeducation

Treatment Summary: Multiple family group psychoeducation (MFG) is a part of the Center for Mental Health Services endorsed evidence-based practice of family psychoeducation (FPE). MFG is a three phase process: stability, community functioning, and building social networks. Sessions take place with two clinicians for an hour and a half approximately every other week. Phase one, stability, takes place over a one year period of time and involves joining with the individual families and education in a multifamily format. The education includes education on relapse prevention and social and vocational rehabilitation. Phase two, community functioning, involves increasing the ability of the client to function in society. Phase three, building social networks, starts at about year three and focuses on creating and sustaining social networks. This addresses the families' continued need for social support and interaction. The MFG setting lends itself to family interactions, problem solving, and emotional and social support. Psychoeducation centers on identifying the difficulties involved when a family member has schizophrenia: the isolation, stigma, and added drain on the family system. The MFG's internal support structure can increase the families' support system and the families help each other by normalizing experiences and fostering hope. The skills and education that families receive help them to aid in the recovery of the client as well.

  • Reference: Jewell, T. C., Downing, D., & McFarlane, W. R. (2009). Partnering with families: Multiple family group psychoeducation for schizophrenia. Journal of Clinical Psychology: In Session, 65,(8), 868-878. doi: 10.1002/jclp.20610
  • Submitter: Jennifer Cherry