Making a review of functions, clinical psychologist and subacute rehabilitation units, I find a long list of psychological treatment for psychosocial intervention: psychoeducation programs for people diagnosed with schizophrenia, schizoaffective disorder and bipolar disorder, emotional self-management programs and social skills, cognitive stimulation programs, family psychoeducation, entertainment, leisure and personal autonomy, cognitive behavioral hallucinations and delusions and so on ...
Well, today we want to ask if there are studies demonstrating the effectiveness of these programs and we've come to the Guide Effective Psychological Treatments for Adult Perez Alvarez Fernández Hermida et al, finding the following conclusions:
- based on sources of various kinds in the psychological treatment of psychotic disorders characterized by pessimism, we are currently in a time of growth and development, multi- forms of psychological intervention, which have led to a gradual shift in attention from the processes of rehabilitation or improvement of symptoms secondary disabilities to focus on the symptoms themselves.
- psychological treatments that have proven effective better recovery in schizophrenia are:
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psychoeducational family interventions - social skills training
- cognitive-behavioral treatments that target both positive symptoms (hallucinations and delusions) , as the underlying basic cognitive processes.
- packages or integrated multimodal group intervention programs to improve social and cognitive skills such as IPT.
- therapeutic elements in common of these treatments would stress the improvement of social and interpersonal functioning, promoting independent living and community maintenance and reduced the severity of symptoms and comorbidities: depression, suicide and drug use.
- the type of treatment chosen will depend largely on when you are the person, and in acute phases raw drug treatment, stabilization and reduced symptomatology environmental demands with work programs simple, stable and predictable in the stable phase of remission symptomatic interventions will begin psychosocial and finally in the subsequent stabilization phase would promote the capacity to maintain community life, using all available resources and work environment in the prevention of relapse.
have also resorted to Guide for professionals and families of psychological treatments used in schizophrenia Elisa Gallach, Salvador Perona, and Francisco José Oscar Vallina Santolaya, which includes both the strategies focused on the individual as those focusing on the environment for the treatment of schizophrenia. Outstanding in
strategies focused on the individual social skills training, psychoeducation of patients, strategies for stress management, psychological treatment of positive symptoms (hallucinations and delusions), Integrated psychological treatment of schizophrenia (IPT) and Cognitive therapy for adaptation to psychosis (COPE). In the section on strategies focused on the environment this review special emphasis on family interventions, vocational rehabilitation and community intervention programs in psychosocial rehabilitation, within which would include programs to reduce social stigma.
Of course there are many other approaches to serious mental disorders, impossible to include in this brief review. Thus, by way of example, as part of change as indicated in our understanding of psychotic experience has been developing a wide range of psychological models to explain psychotic disorders along with their associated psychological treatment. In this vein, Andrew Gumley and Matthias Schwannauer, outlined in his book back to normal after a psychotic disorder a framework for recovery and return to normality, focusing on emotional and interpersonal adaptation to psychosis, comprising all aspects of the therapeutic process of cognitive-relational: adopt a developmental perspective on help seeking and affect regulation . assist the reorganization and adaptation of the person after the experience of acute psychosis. understanding and treating traumatic reactions following the psychotic experience, working on sense of humiliation, suspension, loss, and fear of relapse, cognitive schema relational work and develop coping strategies within a relational context.
Now only the necessary resources, training and motivation of professionals to implement the whole array of treatments, with a focus on recovery and community involvement may be some the key pieces to dramatically improve the prognosis for people with severe mental illness.
Text by Esther Sanz (External Area Clinical Psychologist Mental Health).
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