Rehabilitation of patients with schizophrenia, along with medication treatment, is one of the most critical steps in helping patients with this mental illness. A properly designed and individually designed rehabilitation program assists in organizing one’s life, learning a profession, finding a job, and developing social skills. Plus, it is tremendous psychological support for patients with schizophrenia.
How are patients with schizophrenia treated?
According to statistics, about 1% of all people on the globe have schizophrenia. And although this disease occurs in both sexes, it usually affects men younger than women. In our country, among people with schizophrenia, the percentage of disability is on average 40%. Patients who are completely incompetent or need outside assistance and care will be issued a group. In the second group, people can take care of themselves in everyday life but cannot work. Finally, the third group is given when the form of the disease is mild and when there is a chance that the patient’s condition will stabilize.
Depending on the disability group and the severity of the disease, the psychiatrist prescribes the optimal treatment regimen. Schizophrenia is an illness that significantly changes a person’s personality. People become withdrawn, passive, emotionally cold, detached, and lose their former social connections and interests. The so-called “schizophrenic defect” develops. The stronger it grows, the more the person isolates himself from the world, breaks off connections with family and friends, and loses his job. Today, schizophrenia is treated with medication and antipsychotic drugs. Neuroleptics only relieve exacerbations or prevent them. It is impossible to cure the disease entirely with the help of these drugs.
Complex rehabilitation measures that minimize mental illness manifestations and consequences play a significant role in successful treatment. It is rehabilitation that helps not to lose social ties and preserve the integrity of the personality against the background of the developing schizophrenic defect.
Only those patients are treated as outpatients for schizophrenia who are aware of their illness, are motivated, and agree to undergo therapy voluntarily. If a patient resists and does not consider themselves schizophrenic, in that case, in-patient treatment is needed.
Schizophrenia therapy begins with medication, which includes three main stages:
- Constipation therapy. Started immediately after diagnosis to relieve acute psychosis. Usually, the stage lasts from one to two months.
- Stabilization. In this stage, treatment with antipsychotics continues until remission is achieved. This stage takes, on average, six months from the beginning of an exacerbation.
- Maintenance therapy. It is the longest stage, which takes more than a year and is most often conducted as an outpatient. At this stage, the task of doctors is to preserve and consolidate the results achieved, maintain remission, and prevent disease relapse. It is also when the patient’s social connections begin to be restored.
Rehabilitation in schizophrenia: the main tasks
As a rule, treatment for schizophrenia is prolonged, with patients taking medication for years. But psychopharmacotherapy is not enough to provide the patient with standard conditions for life. Ongoing rehabilitation is needed to achieve this goal.
After the acute period of the illness with pronounced delirium and hallucinations has been overcome with medication, it is possible to move on to supportive therapy and a rehabilitation program. Rehabilitation of people who have schizophrenia helps solve several problems at once:
- It makes the clinical signs of the disease less pronounced;
- Increases the effectiveness of treatment of other psychiatric or somatic disorders which often accompany schizophrenia;
- contributes to the prevention of depression, suicide, and aggression (directed at oneself or others);
- Improves quality of life;
- helps to recover in a profession or learn a new one;
- promotes normalization of intra-family relationships and the creation of a comfortable environment for the patient at home;
- provides legal and psychological support to the family;
- allows to expand the range of social contacts, increase the level of life activity;
- Provides an opportunity to become more independent (learn to serve or live independently).
Without a rehabilitation program, the patient is left to themselves. It significantly increases the risk of psychosis, depression, complete isolation from society, and the final disintegration of the personality. Therefore, the patient needs further support after treating an acute episode.
Types of rehabilitation programs
Rehabilitation of patients with schizophrenia in Russia includes the following types of measures:
- psychoeducation for patients themselves and their relatives;
- training in the development of everyday self-care skills;
- Training in communication skills. Patients are taught to resolve conflicts, communicate with people, and practice assertive social behavior;
- Mutual aid groups (people with the same diagnosis socialize, attend events together, go to theaters and cafes);
- classes aimed at the development of memory, speech, and attention;
- art, bibliotherapy, and music therapy;
- Individual psychotherapy.
Besides social and psychological, professional rehabilitation plays a vital role. Its essence is to help the patient find employment or restore their former position and organize proper employment and activity. Since avoidance of social contacts leads to many people with schizophrenia not wanting to work in the future, one of the rehabilitation goals is to maintain interest and motivation to work.
Rehabilitation for children with schizophrenia follows the same pattern as for adults. The difference is that children do not need to get a job and do not live separately from their parents yet.
How can psychotherapy help a schizophrenic patient?
- One way of rehabilitation is psychotherapy, which can include different patient interaction methods.
- Supportive conversations with a therapist help correct behavior and prevent apathy and depression in the presence of stressors.
- Behavioral therapy is necessary to stimulate cognitive skills and connect with others.
- Small steps therapy helps develop observation and concentration and correct deficiencies in social behavior.
- Cognitive therapy helps the patient to restore life skills, structure the information he receives, protect him from stimuli and, most importantly, recognize early signs of disease relapse in time.
- Family therapy is essential to establish contact between all family members because, without their support, the patient is difficult to cope.
Schizophrenia cannot be cured completely. But through rehabilitation programs, most patients can be helped to normalize their quality of life. It requires considerable effort from the family, doctors, and the patient.