Don't Overlook Psychotherapy for Schizophrenia

Article excerpt

NEW YORK -- Psychotherapy still has a role in the treatment of schizophrenia, Dr. Martin S. Willick reported at a schizophrenia conference sponsored by Columbia University and the New York State Psychiatric Institute.

Although it's true that medications are crucial to treatment, and studies comparing medication alone to psychotherapy alone show that medication is better, "that's not the same thing as saying that psychotherapy is of no value," Dr. Willick explained.

The combination of medication and psychotherapy gives patients the maximum response needed for effective treatment. And psychotherapy also can be helpful for encouraging patients to take their medication.

One aspect of schizophrenia that is problematic for clinicians is a lack of patient insight or patient denial of illness, which is related to specific damage to part of the prefrontal cortex. By working with patients in a therapeutic setting, psychiatrists can help them understand that they can be relieved of troubling symptoms by taking medication.

"Treatment of schizophrenia usually starts with psychotherapy," said Dr. Willick of Columbia University, New York.

Psychologists and other mental health professionals who treat schizophrenic patients must be knowledgeable about antipsychotic medications--particularly about the side effects.

Side effects can sometimes be confused with symptoms of the illness, and therapists must be able to distinguish between the two.

Dr. Willick suggested that the type of psychotherapy that is helpful for schizophrenia is not necessarily the insight-oriented approach made popular in the 1950s and 1960s. This approach is based on the idea that delving into a person's past is helpful in determining why he or she became ill. …