Schizophrenia: Chronic and Severe Mental Disorders
As we know, schizophrenia and its spectrum disorders are chronic and severe mental disorders that affect an individual in many aspects of life. These disorders affect the ability to think and feel, moreover, they affect behavior, meaning that people with schizophrenia may seem as they lost the touch with reality. Sometimes, it can be difficult to diagnose, as there are no tests and the only way to diagnose it is to recognize symptoms that negatively impact on individuals social or occupational functioning. Until recently, schizophrenia has shown very little response to any existing method of treatment, however, it is argued that with psychosocial treatment people suffering from schizophrenia have a chance to adjust socially and improve their wellbeing overall.
As defined by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, schizophrenia is a long-term disorder that can be characterized by bizarre delusions, catatonic behavior, disorganized speech, high relapse rate (70%),and negative symptoms, for instance diminished emotional expression. Usually, the disorder affects people in their late adolescence or early adult life, but there are cases when children were diagnosed too. There are many opinions on what causes schizophrenia. Some people believe that it is in our genes, some people think that it is due to some physical factors like brain damage, metabolic or endocrine disorders, while others state that schizophrenia can be understood only on the basis of psychological factors, meaning that the main causes are mental conflicts and repressions. However, there are people who believe that there cannot be one cause to schizophrenia, in other words, they mean that it arises on the number of causes, such as hereditary, organic, or psychogenic, says Bowman (1939).
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According to Bustillo, Lauriello, Horan, & Samuel (2001), antipsychotic medications have shown to be effective for people suffering from schizophrenia, however, except from clozapine, nothing showed any benefits in different domains, like social adjustment, employment etc. Meaning that most of people who suffer from schizophrenia were still having impaired social functioning and negative symptoms even when taking medication. So, Bustillo, Lauriello, Horan, and Samuel (2001) state that it is extremely important to integrate psychosocial treatment into the standard of care for people who are diagnosed with schizophrenia. Likewise, they argue that without psychosocial treatment the probability of experiencing a relapse is higher.
Family work or psychoeducation may significantly improve the life of a person diagnosed with schizophrenia, state Mueser, Deavers, Penn, & Cassisi (2013). The main reason is that many patients live at home with family or relatives, or have close relationships with somebody from the family. However, most of people do not know how to deal with someone with schizophrenia and this may lead to high levels of family burden and family stress, which in their turn may cause relapse. Family psychoeducation aims to develop collaborative relationships between family and treatment team, so that there was always a progress in treatment. Working with relatives of a person with schizophrenia means that they are taught several strategies how to reduce stress, how to improve communication, and problem solving skill, say Mueser, Deavers, Penn, & Cassisi (2013). Likewise, researchers argue that more than 50 researches conducted that family psychoeducation is extremely beneficial for someone with schizophrenia because it reduces the number of relapses and a little bit improves social functioning.
Another thing that can improve a life of someone with schizophrenia is social skill training. According to Bustillo, Lauriello, Horan, & Samuel (2001), social skill training through learning theory improves social functioning. In other words, working with people suffering from schizophrenia to teach them how to solve problems in their daily lives, leisure and relationships. There are three main forms of social skill training, as stated by Bellack and Mueser (2001). The basic model is a strategy where complex things are broken into simpler ones and people are practicing by playing roles and they try to apply everything in natural settings. Another strategy is called the social problem-solving model. It focuses on improving social skills deficits by ameliorating impairments in information processing. The cognitive remediation model improves things like attention and planning. Bustillo, Lauriello, Horan, & Samuel (2001) state that cognitive impairment can be improved. Meaning that all this learning may support more complex cognitive processes, and if it is going to be taught and generalized in the community, it shows to be beneficial for people with schizophrenia.
Furthermore, there is another psychosocial recovery model that is proved to be beneficial for people with schizophrenia. According to Mueser, Deavers, Penn, & Cassisi (2013), self-management training is about involving people in their own treatment by learning self-managing strategies. In the beginning, people suffering from schizophrenia are usually provided with information about the disorder, so that they could make reasonable decisions about their treatment and care. Besides, patients are taught to take medication as prescribed because medication nonadherence is a quite common reason for relapse, say Mueser, Deavers, Penn, & Cassisi (2013). People with schizophrenia may also learn how to cope with relapse because sometimes medication cannot prevent from it. Mueser, Deavers, Penn, & Cassisi (2013) argue that self-management training helps people to learn how to manage their illness more effectively, in other words, it provides information and skill trainings that may make the life of the patient easier by learning about schizophrenia, medication, relapse prevention, and strategies that help to cope with symptoms.
To sum up with, psychosocial treatment showed to be beneficial for people with schizophrenia due to the fact that they improve wide range of social impairments. For instance, people learn how to be functioning at work, how to form social relationships, how to improve independent living skills, and how to prevent from and cope with relapses. However, further research should be made on questions like how to combine medication and psychosocial treatment in order patients could get better faster and with lower risks of experiencing a relapse.