Describe a comprehensive treatment approach to schizophrenia that would not only be effective but also reduce the risk of relapse

Question

What will be an ideal response?

Answer 1

A comprehensive treatment program would include antipsychotic medications (neuroleptics), psychosocial therapy, and skills training for both the individual and the family. It is quite clear that neuroleptics are effective in reducing symptoms in a large proportion of individuals with schizophrenia. Excessively high doses of these drugs can cause serious side effects and, over long periods of time, the involuntary movements of tardive dyskinesia. For these reasons, a comprehensive treatment approach should monitor drug dosage so that it is at the lowest level while still controlling symptoms.

At the same time, psychosocial therapies should be used to help individuals with schizophrenia gain control of their lives. Milieu therapy in hospital environments provides training in decision making and planning that schizophrenic patients need. Cognitive-behavioral treatments teach necessary coping and social skills. Cognitive-behavioral treatment of schizophrenia often includes the following steps: engagement, assessment, identification of negative beliefs, normalization, collaborative analysis of symptoms, and developing alternative explanations. Mindfulness training teaches patients to let go of angry or fearful responses to psychotic symptoms and let the psychotic symptoms come into consciousness without reacting. This process enhances feelings of self-control and significantly reduces negative emotions. Integrated Psychological Therapy, a highly effective therapy, helps patients identify their cognitive deficits and provides skills to overcome them.

However, since more than half of recovering patients return to live with their parents, treatment must extend to training in family communication—ways to reduce expressed emotion. Therapies that provide information to families about the nature of schizophrenia and methods of communicating without expressed emotion have greatly reduced relapse rates. Individuals with schizophrenia also need to learn coping skills so that they can identify and respond appropriately when family members become emotional. In sum, treatment should combine low but effective levels of medication, psychosocial and cognitive-behavior training, and family interventions designed to reduce relapse. Family and social skills training has proved to be more effective in preventing relapse than drug treatment alone.