Well-designed outcome studies have demonstrated the effectiveness of specific psychological interventions for schizophrenia for over 40 years. Despite this, schizophrenia is still misperceived by many people to be treatable only by medication. In this book, currently available treatments for schizophrenia, and the evidence for their effectiveness, are reviewed. Practical guidance on comprehensive treatment planning of the condition is provided, along with reviews of current theories of schizophrenia, long-term outcome studies and associated remission rates, different classes and types of assessment instruments relevant to psychiatric rehabilitation, and research on mechanisms of recovery. A number of important conceptual issues are interwoven within the discussion, including the relevance of different models for treatment of schizophrenia (the medical model, rehabilitation model, etc.), and the importance of a recovery-oriented perspective.
After completing this course you’ll be able to:
| 1. | State the percent of disabled persons in the United States who are diagnosed with schizophrenia. |
| 2. | Discuss the use of medications in treating schizophrenia. |
| 3. | State why schizophrenia cannot be considered a specific disease. |
| 4. | Define positive symptoms, negative symptoms and disorganized symptoms. |
| 5. | State the goal of psychiatric rehabilitation programs. |
| 6. | Compare recovery in terms of outcome and process. |
| 7. | List the two sets of criteria by which schizophrenia may be diagnosed. |
| 8. | Compare the severity of disabilities from schizophrenia in industrialized and nonindustrialized cultures. |
| 9. | Discuss causes of negative short-term outcomes. |
| 10. | Discuss long-term outcomes of schizophrenia. |
| 11. | State the percent of people diagnosed with schizophrenia who kill themselves. |
| 12. | List the two main medical conditions that are elevated in schizophrenia. |
| 13. | Discuss the role of genetics related to schizophrenia. |
| 14. | List the three birth complications that may play a role in the development of schizophrenia. |
| 15. | Discuss the role of stress and hippocampal damage. |
| 16. | Define pandysmaturation. |
| 17. | Discuss the work of Cantor-Graae and Selton (2005) related to social defeat and stress. |
| 18. | List symptom rating scales that are in widespread use. |
| 19. | Describe the Independent Living Skills Inventory. |
| 20. | Describe the MATRICS project. |
| 21. | State the goal of dynamic assessment. |
| 22. | List the three phases of schizophrenia. |
| 23. | Describe the three steps of the MFM formulations. |
| 24. | Discuss psychiatric rehabilitation and pharmacotherapy as standard practice. |
| 25. | State the initial objective of rehabilitation counseling. |
| 26. | List the five stages of the heuristic model of problem-solving. |
| 27. | Compare supported employment and traditional vocational rehabilitation. |
| 28. | Describe WRAP. |
| 29. | State the two most troublesome and drug-resistant problems in inpatient settings when discussing contingency management. |
| 30. | List the three principles of CBT. |
| 31. | Describe the Soteria Project. |
| 32. | Discuss cognitive enhancement therapy. |
| 33. | Compare the Psychosocial Clubhouse model and assertive community treatment. |
| 34. | List the four mechanisms involved in benefit from treatment in psychiatric rehabilitation. |
| 35. | List the four themes from patient narratives regarding recovery. (Roe 2001) |
| 36. | Compare referential speech and constituitive speech. |
| 37. | List the two PORT recommendations regarding individual and group therapy. |
| 38. | Describe the psychosocial treatment PACT. |
| 39. | Discuss case management. |
| 40. | Describe assertive community treatment (ACT). |
| 1. | Description | ||
| 1.1 | Terminology | ||
| 1.1.1 | Schizophrenia | ||
| 1.1.2 | Positive, Negative, and Disorganized Symptoms | ||
| 1.1.3 | Medical Model | ||
| 1.1.4 | Psychiatric Rehabilitation | ||
| 1.1.5 | Recovery | ||
| 1.1.6 | Evidence-Based Practice | ||
| 1.2 | Definition | ||
| 1.3 | Epidemiology | ||
| 1.4 | Course and Prognosis | ||
| 1.4.1 | Short-Term Outcomes | ||
| 1.4.2 | Long-Term Outcomes | ||
| 1.5 | Differential Diagnosis | ||
| 1.6 | Comorbidities | ||
| 1.6.1 | Psychiatric Conditions | ||
| 1.6.2 | Medical Conditions | ||
| 1.7 | Diagnostic Procedures and Documentation | ||
| 2. | Theories and Models of Schizophrenia | ||
| 2.1 | Genetics | ||
| 2.2 | Theories Involving Viral or Immunopathology | ||
| 2.3 | Birth Complications | ||
| 2.4 | Neuroanatomy | ||
| 2.5 | Neurophysiology | ||
| 2.6 | Neurodevelopment | ||
| 2.7 | Environmental Factors | ||
| 2.8 | Substance Abuse | ||
| 2.9 | Cognitive Factors | ||
| 3. | Diagnosis and Treatment Indications | ||
| 3.1 | Assessment | ||
| 3.1.1 | Symptom Assessment | ||
| 3.1.2 | Functional Assessment | ||
| 3.1.3 | Cognitive Assessment | ||
| 3.1.4 | Dynamic Assessment | ||
| 3.2 | Treatment Planning | ||
| 3.2.1 | Inpatient | ||
| 3.2.2 | MFM Diagnostic Formulations | ||
| 3.2.3 | Outpatient | ||
| 4. | Treatment | ||
| 4.1 | Methods of Treatment | ||
| 4.1.1 | Collaborative Psychopharmacotherapy | ||
| 4.1.2 | Rehabilitation Counseling | ||
| 4.1.3 | Social Skills Training | ||
| 4.1.4 | Problem Solving Skills Training | ||
| 4.1.5 | Independent Living Skills Training | ||
| 4.1.6 | Supported Employment and Occupational Skills Training | ||
| 4.1.7 | Illness/Wellness Management Skill Training | ||
| 4.1.8 | Peer Support | ||
| 4.1.9 | Family Consultation, Education, and Therapy | ||
| 4.1.10 | Contingency Management | ||
| 4.1.11 | Individual Psychotherapy | ||
| 4.1.12 | Supported Housing | ||
| 4.1.13 | Specialized Modes for Service Integration and Provision | ||
| 4.2 | Mechanisms of Action | ||
| 4.2.1 | Recovery-Oriented Perspectives | ||
| 4.3 | Efficacy and Prognosis | ||
| 4.4 | Variations and Combinations of Methods | ||
| 4.5 | Problems in Carrying out the Treatment | ||
| 5. | Case Vignette | ||
| 6. | Further Readings | ||
| 7. | References | ||
| 8. | Appendices: Tools and Resources | ||
“This outstanding work should stimulate a breakthrough in case formulation… A clinical manual of this scope is long overdue.” — Richard H. Hunter, PhD, ABPP, Past Chair, APA/CAPP Task Force on Serious Mental Illness, Clinical Outcomes Group, Inc., and Department of Psychiatry, Southern Illinois University School of Medicine
“The definitive book on schizophrenia, which will prove to be a wonderful resource for clinicians, consumers, researchers, and students. The comprehensiveness of this text is unparalleled in the field.” — David Penn, PhD, Associate Professor of Psychology at the University of North Carolina- Chapel Hill
“An authoritative, concise, and practical synthesis of the nature and treatment of schizophrenia.” — Kim Mueser, PhD, Professor of Psychiatry and of Community and Family Medicine, Dartmouth Medical School, and the Darmouth Psychiatric Research Center
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