Psychosocial therapy

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Medicines are the basis in the pharmacotherapy of schizophrenia. However, there are also other forms of therapy, especially when the patient, unaware of his/her disease, gives up medication, not informing either the doctor or the family.
Sometimes, exceptionally stressful events may trigger a relapse of the disease, even in patients with regular adherence to therapeutic regimen.  It is then important to introduce, simultaneously with pharmacotherapy, other measures which will make the patient aware of the benefits from applied therapy, help to cope with stressful situations and facilitate social contacts.

Remember!

Psychosocial therapy is fundamental for further healing process and for improvement of the quality of life of the patient's family during the period after regression of acute (psychotic, manic, depressive) symptoms.

The psychosocial methods, applied in psychiatric therapy, include:

  • various forms of psychological impacts: psychological assistance, supporting therapy, individual and group therapy, carried out according to various convenstions (cognitive-behavioural, interpersonal, psychodynamic), relaxation, systemic and family therapy, environmental interventions;
  • psychoeducation of the patient and his/her family: communication of the knowledge about the disease, its symptoms, treatment methods, the methods to cope with symptoms, available therapeutic, rehabilitation and support units, the patient's rights, the benefits to which he/she is entitled and of the possibilities of sheltered employment;
  • training of skills: basic life skills, communication and social skills, abilitie to cope with emotionally difficult situations, solving problems;
  • training of cognitive functions;
  • occupational therapy: handicrafts, cooking, fine arts, DIY, art therapy, bibliotherapy, therapy with motion and dance, music therapy, psychodrawing;
  • sociotherapy: therapeutic community, token techniques, various activities in groups, competitions, excursions, get-together evenings, meetings, recreation, sports and cultural and educational activities.
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Stock photo. Posed by model.

Psychotherapy

Psychotherapy in the treatment of schizophrenia or other disorders is a planned therapeutic process, where the therapeutic method includes a psychological impact in individual or group relations with a psychotherapist.
Psychotherapy is provided by a professional (psychologist, doctor) with appropriate theoretical background and practical knowledge. The condition for effective psychotherapy is the patient's motivation towards a change and his/her active collaboration with the therapist or the therapeutic group. There are several trends and methods of psychotherapeutic effects, selected on the basis of psychological diagnosis:
  • cognitive-behavioural psychotherapy,
  • psychodynamic psychotherapy,
  • psychoanalytic psychotherapy,
  • integrative psychotherapy,
  • interpersonal psychotherapy.

Psychologist from the psychological outpatient clinic and psychologist from the outpatient clinic of mental health

A psychologist at the psychological outpatient clinic provides professional services in cases of disturbed personality, eating disorders, neurosis and stress-related disorders. The psychologist is not authorised to provide counselling in cases of psychotic-affective, schizophrenic, delusional or organic disorders.

The scope of services of the psychologist from outpatient clinic of mental health is broader and covers the entire spectrum of mental disorders and diseases. Psychologists at outpatient clinic of mental health or at psychological outpatient clinics receive only referred patients. Such referrals can be obtained from a GP (family or general) or from a psychiatrist at the outpatient clinic of mental health. Appointments with GPs or with psychiatrists do not require any referral.

Psychoeducation

There are many various definitions of psychoeducation. Their majority is focused around the issue of gaining knowledge about the disease and sharing it with other patients.

Remember!

Psychoeducation should be understood as a process, involving patients, their families and therapists, in which information is communicated among the three groups, regarding issues, associated with the patient and his/her family system to improve the functioning of patients and their families.

Psychoeducation is then a process, taking place in the patient-his/her family-his/her therapist system but the information emerging from that single system can be transferred onto other systems, referring to other patients.

The link, which communicates this information, is most often the therapist who makes use of the knowledge, regarding the disease and its management - obtained from one patient and his/her relatives - in the therapy of other patient and his/her family. The patient and their families may also participate in communicating that knowledge to other patients and their families, then the psychoeducation takes a group format.

It is worth knowing that...

Psychoeducation is a continuous and variable process and its main objective is not only the reduction of disease symptoms or reminding the patient to take medicines. It also aims at enabling the patient and his/her relatives better psychosocial functioning, even despite psychotic symptoms.

Psychoeducation in schizophrenia focuses on the foundations and styles of coping with the disease, on the resources of knowledge and possibilities which are necessary to fight schizophrenia and achieve healing process. Psychoeducation allows also to cope with emotional aspects of mental disease and its effects.

Many researchers understand psychoeducation as a kind of prophylactics against disease relapses and for improved compliance of patients with prescribed medication regimens, however, one may say that psychoeducation, based on these two factors, will not fulfil the majority of objectives of this psychosocial therapy nor will it respond to all the expectations of patients and their families.

Moreover, the "effective life" of such a form of psychoeducation is rather short and will meet with the interest of patients and their relatives only during its first application. On a subsequent attempt to make use of psychoeducation, focused merely on the prevention of disease relapses and/or improved medication, it ceases to be "effective" - the patient and his/her relatives begin to understand that the "recommendations" were not effective, at least, in the patient's case, since the relapse did happen.

It is worth knowing that...

The primary goal of psychoeducation concentrates on fulfilling life objectives, significant for the patient and on improvement of his/her life, among others, by more effective coping with stress of all the family members, strengthening communication and improving the capacity to solve problems.

Psychoeducation not only enables to expand the knowledge of patients and their families, regarding the disease and its therapy, but it also allows for reduction of the negative symptoms of schizophrenia, improves interpersonal functioning of patients, decreases the risk of relapse and, even if these benefits are still not available, it allows for shortening of inpatient psychiatric care.
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