Because the causes of schizophrenia are still unknown, treatments focus on eliminating the symptoms of the disease. Medication is not enough to treat schizophrenia. Support groups and a support systems are very helpful.
When a patient is unaware of the illness, a "doctor knows best" or "father/mother knows best" approach will not work, because there is no agreement on the problem: Do not expect gratitude, receptiveness, or adherence via this method. Instead, you should expect fear, anger, suspicion, loneliness and demoralization, overt and secretive "noncompliance".
What should be done in the case of lack of awareness is creation of a respectful, non judgemental relationship that will result in acceptance of treatment- not the acceptance of diagnosis.
The LEAP Approach:
L: Listen (reflectively w/o judgement and with respect)
E: Empathize (strategically with emotions stemming from delusions and lack of awareness)
A: Agree (find areas of agreement - abandon the goal of agreeing the person is sick)
P: Partner (on those things you can agree on - not being ill)
Delay- Giving opinions like "You're ill and need medicine"
Opinion- The Three A's Apologize for such opinions, Acknowledge fallibility, Agree to disagree)
Apologize- For not agreeing, too much reflective listening, involuntary hospitalization, etc.)
Treatments Include:
Antipsychotics- Antipsychotic medications are usually taken daily in pill or liquid form. Some antipsychotics are injections that are given once or twice a month. Some people have side effects when they start taking medications, but most side effects go away after a few days. Doctors and patients can work together to find the best medication or medication combination, and the right dose.
Psychosoical Treatments- These treatments are helpful after patients and their doctor find a medication that works. Learning and using coping skills to address the everyday challenges of schizophrenia helps people pursue their life goals, such as attending school or work. People who participate in regular psychosocial treatment are less likely to have relapses or be hospitalized.
Coordinated Specialty Care- This treatment model integrates medication, psychotherapies, case management, family involvement and supported education and employment services, all aimed at reducing symptoms and improving quality of life. The NIMH Recovery After an Initial Schizophrenia Episode (RAISE) research project seeks to fundamentally change the trajectory and prognosis of schizophrenia through coordinated specialty care treatment in the earliest stages of the disorder. RAISE is designed to reduce the likelihood of long-term disability that people with schizophrenia often experience and help them lead productive, independent lives.
While no cure exists for schizophrenia, it is treatable and manageable with medication and behavioral therapy, especially if diagnosed early and treated continuously. Those with acute symptoms, such as severe delusions or hallucinations, suicidal thoughts or the inability to care for oneself, may require hospitalization. Antipsychotic drugs are the primary medications to reduce the symptoms of schizophrenia. They relieve positive symptoms through their impact on the brain's neurotransmitter systems. Cognitive and behavioral therapy can help "refrain" the brain once symptoms are reduced.
These approaches improve communication, motivation, and self-care and teach coping mechanisms so that individuals with schizophrenia may attend school, go to work and socialize. Patients undergoing regular psychosocial treatment comply better with medication and have fewer relapses and hospitalizations. A positive relationship with a therapist or a case manager gives a patient a reliable source of information about schizophrenia, as well as empathy, encouragement and hope. Social networks and family member support have also been shown to be helpful.
