What Kind Of Therapy Is Helpful For Schizophrenia?

Schizophrenia is a mental illness that can affect the way individuals perceive and interact with the world. Although it can be a challenging condition, a variety of therapies are available to help people with schizophrenia manage their symptoms and improve their quality of life. Below, we’re going to outline common forms of therapy used to treat schizophrenia, provide an overview of the disorder, and discuss other treatments used to manage symptoms.

Schizophrenia – Overview of the mental illness

Schizophrenia is a mental illness that can affect the ways a person perceives reality, interacts with others, and manages emotions. Those with schizophrenia may experience delusions, hallucinations, and challenges related to relationships and responsibilities. Schizophrenia symptoms are typically categorized as positive or negative symptoms.

Positive symptoms, which are defined as those that cause any change in thoughts or behavior, may include:

• Hallucinations: the experience of perceiving phenomena (e.g., hearing voices, seeing visions) that are non-existent 

• Delusions: beliefs that are not based in reality (e.g., a belief that you have magical powers)

• Catatonia: a condition in which a person stops speaking or moving for an extended period

Negative symptoms often involve an individual withdrawing from social interactions, the environment, and their own emotions. Negative symptoms of schizophrenia may include:

• Reduced emotions or expression of emotions

• Reduced energy or motivation

• Loss of interest in activities

• Social withdrawal

• Reduced speaking or interaction

Individuals with schizophrenia may also experience cognitive symptoms. These can include:

• Difficulty with decision-making

• Challenges with absorbing and using information

• Difficulty concentrating

In addition, those with schizophrenia may experience episodes of psychosis, which may aggravate their other symptoms. According to the National Institute of Mental Health, an episode of psychosis can involve the disruption of a person’s thoughts and perceptions, during which the individual may have difficulty recognizing what is real and what is not. 

The symptoms of schizophrenia typically emerge in a person’s late teens or early twenties. A diagnosis of schizophrenia can be made by eliminating other potential underlying causes of a person’s symptoms (e.g., another mental health or medical condition), reviewing their mental health and family history, and conducting a psychological assessment. When diagnosing schizophrenia, professionals typically look for at least two of five primary symptoms of the disorder. 

What does treatment involve?

There is no known cure for schizophrenia. Still, early intervention and treatment can help to reduce symptoms and improve quality of life. Several treatment options are available to treat schizophrenia, including:

• Antipsychotic medication: Antipsychotic medications are the most common medical treatments for schizophrenia. They may be classified as either ‘typical antipsychotics’ such as haloperidol or ‘atypical antipsychotics’ such as aripiprazole. Potential side effects of antipsychotics include fluctuations in weight, dizziness, motor function challenges, and fluid retention. 

• Psychotherapy: This form of therapy is aimed at providing individuals with the tools and techniques to manage their thoughts and emotions. Psychotherapy for schizophrenia can take many forms, including cognitive behavior therapy and cognitive enhancement therapy. 

• Psychosocial therapy: Psychosocial therapy is designed to help those with schizophrenia navigate social situations, interactions, daily responsibilities, and relationships. 

An individual’s treatment program may consist of multiple modalities; for example, an individual may be directed to take antipsychotic medication, participate in therapy, and engage in social skills training. 

Therapy modalities and treatment options

Schizophrenia therapy can take a variety of forms. Thus, it may be helpful to explore common types of therapy and their accompanying techniques in more detail.

Therapeutic treatment for schizophrenia typically falls into two broad categories: psychosocial therapy and psychotherapy.

Psychosocial therapies

Because individuals with schizophrenia can experience significant impairments in occupational, social, and self-care skills, successful treatment often involves focusing on these challenges. Psychosocial therapies are modalities that can help individuals with schizophrenia limit effects symptoms have on everyday functioning. Individuals can also help participants adhere to their treatment program. According to the National Alliance on Mental Illness, people who undergo psychosocial therapy are “more likely to continue taking their medication and less likely to relapse”. The following are commonly utilized psychosocial therapies. 

Assertive community treatment (ACT)

This form of therapy for schizophrenia is designed to help individuals experiencing severe mental illness integrate into their communities, get resources, treatments, and education, and learn vocational and life skills. Examples of ACT techniques include vocational training, social events, medication assistance, and substance use counseling. 

Social skills training

Social skills training is aimed at helping those with schizophrenia develop and improve their social skills. It may include techniques such as role-playing as well as take-home exercises and assignments designed to help individuals practice the skills they’ve learned on their own. 

Coordinated specialty care

Also known as CSC, this form is aimed at helping those experiencing their first psychotic episode reduce their symptoms and achieve the best possible long-term outcomes. Techniques involved in this form may include education, employment assistance, family education, and medication management assistance. 

Psychotherapies

Talk therapy can help participants address schizophrenia’s emotional and cognitive challenges, as well as symptoms of comorbid mental health challenges. Research shows that therapy is an efficacious form of care when used as an adjunctive treatment to medication. The following are commonly utilized modalities.  

Cognitive enhancement therapy

Also known as CET, cognitive enhancement therapy is a form of cognitive remediation designed to help those with schizophrenia improve their attention spans, focus, problem-solving skills, and ability to carry out social interactions. Techniques may include group exercises, simulations, and other computer-based activities. 

Art therapy

Art therapy is a form of aimed at helping those with mental health conditions explore and express their thoughts and emotions while managing stress, developing social skills, and improving self-esteem. Research suggests that adjunctive art therapies may reduce some negative symptoms of schizophrenia. An art therapist may conduct individual or group sessions. Group sessions provide the added benefit of fostering socialization among group members with schizophrenia, who may otherwise withdraw from social situations. Techniques may include drawing, sculpting, painting, collage, and photography. 

Cognitive behavior therapy

Also known as cognitive behavioral therapy, cognitive behavior therapy (CBT) is a form of talk therapy. It is designed to help individuals better understand their own ways of thinking and learn to reframe unhelpful patterns, habits, and beliefs. By identifying and replacing disordered thoughts, an individual with schizophrenia may be able to limit negative feelings and behaviors. CBT techniques may include journaling, restructuring thoughts, and practicing new ways of thinking.

Interventions with family members

Family support can be vital to deriving positive outcomes from treatment. Family members can help people with schizophrenia solve problems, improve social functioning, and develop coping skills for use in everyday life. Family interventions can also help ensure the individual follows their treatment plan, with research showing that they improve treatment adherence. A common family intervention for individuals with schizophrenia is family therapy. This modality focuses on how family dynamics may influence the person with schizophrenia and other family members.  

Mental health care with online therapy

Because those with schizophrenia may experience challenges with motivation and low energy, attending in-person counseling sessions may not always be feasible. In these cases, online therapy through platforms like BetterHelp may be a useful resource due to the ability to attend sessions from wherever it is most convenient. The option to send messages to a counselor outside of scheduled sessions may also make internet-based therapy an appealing option for those who need extra support while implementing similar strategies into their daily lives. 

Online counseling has been determined to be an effective alternative to in-person counseling. A 2017 study found that internet-based cognitive behavioral therapy was effective at treating a variety of psychiatric disorders, including adjustment disorder, bipolar disorder, phobias, generalized anxiety disorder, depression, and panic disorder. In addition, a 2021 study encouraged health service providers to offer more online interventions and treatment programs for those with schizophrenia, as their research suggested an unmet need for those services may exist.