Subject(s)
Psychotherapy/methods , Schizophrenia/therapy , Adolescent , Adult , Family , Female , Humans , Male , Middle Aged , Prognosis , Schizophrenic Psychology , Social AdjustmentABSTRACT
This is an account of a long-range action research project to determine indications for and effects of a comprehensive psychotherapeutic approach, including various treatment modalities, in the treatment of schizophrenics. Four diagnostic groups were established among the 100 patients. In the course of data analysis, the group of typical schizophrenics (56 percent) was contrasted to or compared with the entire series. A further diagnostic differentiation was established according to ego functioning; i.e., imminent, acute, regressive, and paranoid ego disintegrations, respectively. Patients and family members were interviewed upon admission, and again two and five years later, and the data recorded on a 163-item form from which 40 clinical and psychosocial variables were constructed after the baseline examinations. In addition to cross-tabulation, logistic regression analysis was employed. The conclusion that the follow-up study supports the effectiveness of our global psychotherapeutic approach to treating schizophrenia seems justified. Results so far indicate that five modes of therapy in addition to drug treatments are optimal for different patients. The five modes are long-term individual psychotherapy, couple or conjoint family therapy for married patients, family therapy with the family of origin, flexible short-term crisis intervention with a family focus, and extensive long-term treatment focused on social rehabilitation for the most ill-starred patients.
Subject(s)
Psychotherapy/methods , Schizophrenia/therapy , Adolescent , Adult , Crisis Intervention , Ego , Employment , Family Therapy , Follow-Up Studies , Humans , Middle Aged , Prognosis , Psychotic Disorders/psychology , Psychotic Disorders/therapy , Regression, Psychology , Schizophrenia, Paranoid/therapy , Schizophrenic Psychology , Therapeutic CommunityABSTRACT
The authors have developed a psychotherapeutic approach to schizophrenia within the community psychiatric health care system. The orientation is psychodynamic but global in the meaning that the therapeutic plans are made on the basis of case-specific need of the patients and of their families and include both individual psychotherapy, family therapy and therapeutic communities. The material is composed of 100 successive patients of the schizophrenia group aged 16 - 44 years and for the first time admitted for treatment into the different units of the Turku Mental Health District in 1976 - 77. A multiprofessional staff was acting as therapists, supported by a continuous and intensive on-the-job -training and supervision. The results preliminary reported in this paper are based on a follow-up study 5 years after admission to treatment. 56 patients could be included in the psychotherapy group given at least some mode of psychotherapy in an adequate amount. The background variables of patients selected for various modes of therapy as well as the prognostic results are studied with the aid of logistic regression analyses. The findings indicate that the development of a global psychotherapeutic orientation is possible in the field of community psychiatry and yields results that demonstrate its meaningfulness. The implementation of psychotherapy had clearly positive explanatory connections with a favourable prognosis, and although these connections were not equally strong as the connections of some central clinical and psychosocial variables, they were obvious and manifold.
