This article surveys three types of psychological interventions (i.e. individual psychotherapies, group psychotherapies, and psychosocial skills training) for people with schizophrenia regarding their degree of effectiveness. Assuming patients are receiving adequate therapy, this article poses the following questions:
1. Do any of these interventions reduce relapse or psychopathology in persons with schizophrenia?
2. Do any of these interventions improve social or vocational functioning in persons with schizophrenia?
3. For psychosocial skills training, is there evidence that:
· this intervention results in skill acquisition by persons with schizophrenia?
· the effects persist over time?
· the effects generalize from the training setting into “real life”?
As part of their cases studies, the authors used their own patients. But they used more from cases they have unearthed from Psyclit and Medline databases. They discovered that the research literature and case studies on individual and group psychotherapies are outdated (i.e. at least 10 years old) and methodologically flawed. However, those papers on psychosocial skills training are more acceptable. They are very recent and had more “controlled trials.”
Accordingly, individual therapies do not really reduce symptoms, rates of relapse and hospitalization, nor do they help the patient adjust socially (Gomes-Schwartz 1984). Some studies suggest that group psychotherapy may be harmful (Schooler and Keith 1993). Despite the fact that psychosocial skills training appears to be the best of the three types of interventions, studies indicate that this type of therapy at best is limited in terms of the results.
The authors admit that the research methodologies of many of their cited researches and studies are limited or ineffective, so future studies must be made. However, some conclusions can be made:
First, individual or group psychotherapies are ineffective at best and harmful at worst.
Second, psychosocial skills training are effective up to a certain extend but better models must be created to improve outcomes.
Notice that the authors admit that there is a relative lack of merit of for many available literature or studies. This begs the question. Suppose that the research literature and studies available were closer to the ideal, and that the methodologies used by those studies were more sound and credible. Would the conclusions provided by the authors remain the same? The authors desire more reliable and valid studies, so different possible outcomes are likely. If, however, the same conclusions appeared despite better research findings were available, then the conclusions made by the authors would be placed on a more solid footing.
Therefore, in the same way that the concept of schizophrenia is still ill-defined, there exists no totally effective psychological treatment for schizophrenia (or to be more politically correct, to the symptoms which characterize “schizophrenia”).
According to p. 497 of our textbook:
Historically, a number of psychosocial treatments have been tried for schizophrenia, reflecting the belief that the disorder results from problems in adapting to the world because of early experiences (Nagel, 1991). Many therapists have thought that individuals who could achieve insight into the presumed role of their personal histories could be safely led to deal with their current situations. Although clinicians who take a psychodynamic or psychoanalytic approach to therapy continue to use this type of treatment, research suggests that their efforts at best may not be beneficial and at worst may be harmful (Mueser & Berenbaum, 1990; Scott & Dixon, 1995b)
The concept of mental illness including schizophrenia is questioned by many psychiatrists from the Anti-psychiatry Movement. The corresponding concept of normality is also an open question. Perhaps, a major overhaul of our conceptions of abnormality may be needed in order to produce more valid and desirable results.
Schizophrenia is a debilitating mental disorder. Its accompanying symptoms render many afflicted people unproductive. So, effective therapy is needed. Even though the concept of schizophrenia (ill-defined to some extent) has been around for a hundred years, no effective and final form of treatment is available. Therefore, research in schizophrenia is a vast and open field. Researchers, from those who have faith in Psychiatry and those from Anti-Psychiatry, are welcome to conduct research and contribute to existing knowledge in search for that holy grail of finding a perfect cure or treatment for schizophrenia, even though schizophrenia (by current convention) has no cure.
It is also the job of students of Abnormal Psychology or Psychiatry to be more aware of current research in schizophrenia. They have to decide as early as possible whether they would want to contribute in future research, since a breakthrough would greatly help many people afflicted with schizophrenia.