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Priority Topic: Schizophrenia

7/24/2018

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Key Feature 8: Include psychosocial supports (ex: housing, family support, disability issues, vocational rehabilitation) as part of the treatment plan for patients with schizophrenia.
Skill: Patient Centered, Clinical Reasoning
Phase: Treatment

While pharmacotherapy is a mainstay of treatment for schizophrenia, there is more to be done than chemically treat. The UpToDate article, "Psychosocial interventions for schizophrenia" provides suggestions for how to provide psychosocial supports for patients with schizophrenia, and they include the following:
  1. Family-based interventions
    1. "For individuals with schizophrenia who have had a recent psychotic relapse, have significant ongoing contact with family members and have not previously received the intervention, we recommend that the patient and family members receive a family psychoeducational intervention. The intervention is typically provided in monthly sessions with an individual family or a group of families for six to nine months as augmentation to antipsychotic medication and other treatment."
    2. "For individuals with schizophrenia who have experienced multiple psychotic relapses, and reside in a particularly stressful family environment, we suggest treatment with a more intensive problem-solving family therapy over other family psychoeducational interventions."
  2. Cognitive-behavioural therapy
    1. "For individuals who experience persistent delusions or hallucinations despite adequate trials of antipsychotic medication, we recommend adjunctive treatment with cognitive behavioral therapy over medication alone."
  3. Social-skills training
    1. "For individuals with schizophrenia who have deficits in skills needed for everyday activities, we recommend social skills training as an adjunct to antipsychotic medication over medication alone. Social skills training is generally conducted several times a week (either in training sessions with a clinician or in patient practice sessions) for three to six months. Manuals and other materials are available to support training and provision."
  4. Assertive community treatment 
  5. Supported employment
  6. Supportive housing
​
Treatment of schizophrenia ought to include antipsychotic therapy, but therapy as a whole is not JUST about antipsychotic medications.
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