Schizophrenia Therapy Techniques You Should Know

Schizophrenia is a serious mental health disorder characterized by disruptions in thoughts, emotions, perceptions, and social interactions. While medication is often recommended to treat symptoms of schizophrenia, talk therapy can play a critical role in symptom control, the development of coping mechanisms, and long-term improvement in one’s quality of life. In this article, we dive into common therapy techniques you may want to be aware of when seeking mental health care for schizophrenia. 

Schizophrenia – Overview of the mental illness

Schizophrenia is a mental disorder characterized by disturbances of an individual’s thoughts, feelings, and behaviors. Schizophrenia can be separated into positive and negative symptoms. Positive symptoms of schizophrenia are those that are atypically present, including delusions, hallucinations, and disorganized speech and behavior. Negative symptoms of the mental illness are those that are atypically deficient or absent, including flat affect, social isolation, and lack of motivation. The following are common categories of schizophrenia symptoms. 

Delusions

Some of the most common persistent symptoms of schizophrenia are firm beliefs that have no basis in reality. Delusions may be related to irrational fears of being pursued by certain authorities or illogical ideas about an individual’s abilities or status.

Hallucinations

Chronic schizophrenia can impact an individual’s senses, causing them to perceive visuals, sounds, or feelings that are not present. People who experience hallucinations may believe they’re watching their relatives on TV or hearing voices that aren’t real.    

Disorganized speech and thought

People with schizophrenia may struggle to form coherent ideas, which can cause them to also speak in ways that are nonsensical or confusing. An individual with the disorder may respond to a question with a non sequitur or use words incorrectly. 

Disorganized behavior

Schizophrenia can cause individuals to act in unexpected or abnormal ways. Examples of abnormal behavior include inappropriate physical movements and catatonia, which is a state of unresponsiveness and seeming lethargy.  

Negative symptoms

A lack of motivation, social isolation, and flat affect (a lack of emotional expression) are some of the negative symptoms of schizophrenia. Friends and family members of people with schizophrenia may also notice a lack of ability to experience pleasure, known as anhedonia. Negative symptoms are considered a primary source of the functional impairments that are associated with this serious mental illness. 

How common is schizophrenia?

The onset of schizophrenia often occurs in later adolescence or early adulthood and affects both men and women. Men tend to have an earlier onset of schizophrenia than women. For those living with schizophrenia, managing symptoms effectively can make a significant difference in relationships, school and work success, and personal fulfillment. 

Therapy techniques for schizophrenia

Typically, antipsychotic medications are the primary component of schizophrenia treatment plans. Antipsychotics can reduce symptoms like delusions and hallucinations that are common in schizophrenia and other psychotic disorders (e.g., schizoaffective disorder). Always consult with a healthcare provider prior to starting or stopping any medication. A professional can discuss the potential side effects of a prescription drug and how that medication might fit into a schizophrenia treatment plan.  

An individual’s treatment team may also suggest mental health services like electroconvulsive therapy or vocational rehabilitation. Another common modality used to treat schizophrenia is individual therapy. Therapy for schizophrenia can help alleviate the emotional challenges of the disorder, identify unhelpful thoughts, and address potential comorbidities. 

Therapeutic techniques, such as cognitive behavioral therapy (CBT), cognitive enhancement therapy (CET), family therapy, social skills training, and assertive community treatment (ACT), are often used to help people with schizophrenia reduce unwanted symptoms and improve in different areas of life. 

Cognitive behavioral therapy (CBT)

Cognitive behavioral therapy (CBT), sometimes called cognitive behavior therapy, is a well-established form of therapy that utilizes elements of both cognitive therapy and behavioral therapy. It is used widely for treating various mental health disorders, including schizophrenia. CBT for schizophrenia typically focuses on helping individuals understand their symptoms and develop strategies to manage them effectively. These can include challenging delusional beliefs, reducing anxiety, and improving social skills.

Cognitive and behavioral techniques that may be used include changing self-talk, finding ways to check for what is real, and identifying how a person came to adopt delusional beliefs. Cognitive behavioral therapy can also help individuals develop healthy coping strategies for the emotional and cognitive challenges of schizophrenia. 

Additionally, research suggests that CBT may work when other treatment methods do not. In one randomized controlled trial, researchers concluded that CBT is an effective treatment method for schizophrenia resistant to medication. However, other studies have shown that CBT’s effects can be limited if medication is working. Researchers in one study concluded that “adding cognitive behavioral therapy to pharmacotherapy brings about a minimal improvement in overall symptoms”.

Intensive cognitive behavior therapy

Intensive cognitive behavior therapy is a brief form of CBT marked by fewer—but typically longer and more concentrated—sessions than traditional CBT. Treatment outcomes from one study, titled “Randomised controlled trial of intensive cognitive behavior therapy for patients with chronic schizophrenia”, show that intensive CBT led to significant decreases in symptom severity. Researchers in the controlled trial suggested that intensive CBT can be an effective adjunct method of treating patients with schizophrenia.

Cognitive Enhancement Therapy (CET)

Cognitive enhancement therapy (CET) is a type of cognitive training designed to help patients with schizophrenia build social and cognitive abilities. Participants in this type of training may increase the speed with which they process information, as well as improve memory and language ability. This type of treatment may be especially useful in helping people in the early stages of schizophrenia recover.

Family therapy

Family therapy is another approach to mental health care that can lead to significant improvements in schizophrenia symptoms. This type of intervention centers on the belief that stabilizing the family environment can prompt a reduction in schizophrenia symptoms, as family members often end up providing care to a person with schizophrenia. 

Family therapy aims to educate family members about schizophrenia and its associated symptoms, increase communication among family members, reduce stress surrounding the disorder, and build a supportive counseling environment. This type of therapy can help families cope with the diagnosis more effectively and reduce the likelihood of relapses. There is also evidence that family therapy sessions can help individuals with schizophrenia stick to their pharmacological treatment. In one study, researchers found that a family intervention focused on education led to significant improvements in medication abidance.

Social Skill Training (SST)

Social skills training is a type of behavioral training designed to help individuals with serious mental illnesses, including schizophrenia, improve their interpersonal social abilities. This training can include role-playing exercises, interactive activities, and exposure to different social environments. Participants in this type of psychosocial therapy may work on skills that help with making friends, conversing with others, enjoying free time, having successful interactions with healthcare providers, and managing situations that involve drugs or alcohol.

Assertive Community Treatment (ACT)

Assertive community treatment (ACT) is an intensive, team-based approach to therapy designed to provide comprehensive, community-oriented care to people with serious mental health conditions, such as schizophrenia. ACT teams often include a range of mental health professionals such as psychiatrists, social workers, nurses, and vocational specialists. Research has found that people with schizophrenia are more likely to stick with ACT treatment compared to other types, and the treatment also helps people stay on their medication and develop improved social skills.

Can online therapy benefit schizophrenia?

Online therapy, or teletherapy, can provide benefits to those who live with schizophrenia. The nature of schizophrenia and its symptoms sometimes make it challenging for people to seek help or adhere to treatment plans, particularly when doing so involves visiting clinics or healthcare centers. Online therapy, which allows people to receive treatment from the comfort and safety of their homes, can reduce these barriers and improve treatment availability.

The structure and routine that online therapy provides may be especially helpful for maintaining session consistency. Online therapy can facilitate regular, consistent contact with therapists, which can be key to managing symptoms and preventing relapses. In addition to this, online platforms like BetterHelp often include scheduling tools, reminders, and goal tracking, which can be particularly helpful for individuals with schizophrenia who are trying to stick to a treatment regimen. 

Is online therapy effective?

The effectiveness of online therapy for treating mental health disorders, including schizophrenia, has been shown in several research studies, including those with randomized controlled trials. In one study, researchers found that an internet-based cognitive behavioral therapy (CBT) intervention improved auditory hallucinations in people living with schizophrenia. Additionally, participants reported high satisfaction and engagement with the program, and some also experienced increases in social functioning. 

Cognitive behavioral therapy is an approach to treatment that focuses on the link between an individual’s thoughts and behaviors. Participants can learn how to change their unhelpful thoughts, which may help them reduce unwanted behaviors and emotional responses.