Schizophrenia

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Therapies

• Inpatient therapy
• Partial hospitalization and intensive outpatient services
• Social skills training
• Family therapy

Inpatient therapy has saved the lives of millions of people who suffer from schizophrenia. Primarily, inpatient therapy allows for emergency treatment and intervention in cases where people become suicidal, homicidal, or when diminished self-care endangers their well-being. This becomes especially important during psychotic episodes. Assessments of the disease and its prognosis are possible during an extended hospital stay. Furthermore, a plan may be established for management of the disease. Patients learn about their disorder, its treatment, and its prognosis in a safe, controlled environment.

Partial hospitalization is necessary in some cases of relapse and is mostly used as a follow-up to inpatient care. Other partial-care options include living communities, like supervised housing, where medical professionals oversee daily routine and medication. Such situations allow the person to reclaim some autonomy while receiving support, maintenance, and care for their disease. Supported living situations of this type reduce the need for hospitalization and encourage recovery, as well as assimilation back into normal life after extended inpatient care.

Social skills training, on an outpatient basis, gives people the resources they need to return to work, school, family, and self-care. The following skills are focused on to regain and strengthen function:

• Forming and maintaining relationships
• Learning to be a coworker
• Caring for the body (e.g., hygiene)
• Providing for needs, shopping, cooking, dressing, and so on
• Managing emotion
• Communicating with others
• Solving problems, creating solutions to life�s daily dilemmas
• Self-sufficiency

Family therapy is aimed at reducing familial stressors that seem to trigger episodes and relapses. For example, so-called high emotional energy families are not the best environments for people with schizophrenia. Their comments may be hostile and hypercritical, and their intrusive behavior, although intended to be helpful, may only exacerbate an already irritable person. Family therapy is intended to educate families and to change this type of dynamic, so that an environment conducive to recovery can be created. Intervention with families may reduce symptoms and result in better prognoses.

Legal Issues
Because judgment is compromised for people with schizophrenia, they often do not realize that they need treatment. In some cases, physicians admit people to hospitals against the patient�s will. In fewer cases, physicians have to medicate people who refuse to be treated. Often, the courts intervene and mandate hospitalization or medication. Involuntary hospitalization and medication is more common in schizophrenia and psychotic disorders than in other mental disorders.

A few criteria must apply to a resistant person before the courts get involved in the decision to hospitalize. Each state has its own criteria for involuntary treatment. Generally, the person must pose an imminent danger to society or to him- or herself.

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