Schizophrenia is a chronic mental illness marked by impairments in cognitive, emotional, psychosocial, and occupational functioning, as well as atypical behavioral expressions such as delusions, hallucinations, social withdrawal, and motivation. Schizophrenia affects around 23 million people globally, according to the World Health Organization, and schizophrenics are 3 times more likely than the general population to die young (Charlson et al., 2018). Schizophrenia affects roughly 1.1 percent of the adult population. The patient’s chronic sickness has an impact on every part of his or her life. With this perspective, treating a diseased patient tries to alleviate pain, eliminate symptoms, and heal the patient. Medication is necessary in the treatment of Schizophrenia, just as it is in the treatment of any other mental condition. Pharmacists play a key role in assisting patients in recovering from or at least coping with the effects of such diseases. As an adjunct to pharmacological treatment, relapse intervention programs have been developed to aid recovery and improve functional outcomes. Family interventions, psycho-educational interventions, cognitive therapy, social skills training, and personal medicine are just a few examples of rehabilitative intervention programs. This paper determines the effectiveness of these intervention strategies and their applicability in the treatment of schizophrenia.
There is currently no treatment or cure for schizophrenia. Early diagnosis, as well as proper pharmacological and psychosocial therapy, are essential for minimizing disease’s effects. During an acute episode, patients may need to be admitted to the hospital for stabilization. The intensity of the episode will determine whether or not a hospitalization is required. Intense outpatient treatment can help with mild or severe bouts. A person with schizophrenia should be discharged from a outpatient facility with a treatment strategy that will help them manage their symptoms and promote wellness.
Family interventions
Schizophrenia can cause distress and difficult experiences for both individuals with schizophrenia and their families. Since the members of the family are the primary caregivers for the patient, caring for the patient can be burdensome, which is associated with various aspects of physical, emotional and socioeconomic problems. Family intervention mainly involves approaches which may be in a group format or individual format where the patient and family members meet together to discuss and share skills on how to improve the situation. According to a study conducted in Spain, patients were put into two groups, a family intervention group and a control group that received standard treatment (González et al., 2018). This study showed that the hospitalization risk for patients who received family intervention was 40% less compared to the control group. Positive symptoms and social disability are also seen to reduce significantly after 12 months.
Even though a caring and supportive home environment can be stimulated through family education and consortium in treatment planning and implementation, families’ increased competence and ability to identify and alert mental health providers about any warning signs of relapse are critical for relapse prevention in schizophrenia, avoiding long delays in treatment, and achieving early recovery. Therefore, family interventions are highly effective because a close relationship between patients and their family members enables family-based interventions which improve the patients’ recovery process and their ability to manage the illness.
Psycho-educational programs
Psycho-education refers to the structured and systematic information about the disease and its treatment, which also comprises of integration of emotional aspects to help patients and their family to handle the illness. Methods used to measure the effectiveness of psycho-education include; degree of symptoms, relapse rate, knowledge of the illness and adherence to treatment. According to a meta-analysis conducted by Cochrane comparing standard treatment to effectiveness of psycho-educational interventions revealed that psycho-educational intervention reduces relapse rates at 9-18 months (Hersche et al., 2021). According to the research, relapse rates can be reduced by 12%. Psycho-education is effective because patients and their family understand the illness and treatment.
Psychoeducation programs for both patients and their families have managed to accumulate much data supporting their efficacy in overall state of mind, treatment adherence, relapse prevention, and gratification with mental health services, and it is recommended that they be incorporated into a family-based or multi – component psychological treatment (including illness management, supported employment, and satisfaction with mental health services).Therefore, they can better cooperate with caregivers to work towards patients’ recovery, and they can also live healthier and quality lives.
Cognitive therapy program
It involves cognitive behavioral therapy (CBT) and cognitive rehabilitation. CBT is a greatly structured therapy that helps individuals with schizophrenia to manage their psychotic symptoms by linking their feelings and their thinking patterns which cause their perceived experiences. Cognitive rehabilitation involves helping patients in retention of basic processes like memory, processing speed and attention span to improve the functioning of patients. More than 40 controlled trials have been conducted on cognitive therapy and their results and conclusions were similar. These studies revealed that cognitive therapy improves socials kills and decreases positive symptoms, and these effects are long-lasting, usually more than 1 year. Cognitive therapy is, therefore, an efficient way to handle functional impairments related to symptoms. It is effective in the reduction of symptoms and improvement of social functioning.
CBT necessitates competent and talented practitioners, a clear understanding of the intervention’s important and effective components, and management of patients’ practical needs in terms of time for frequent sessions and the need for high concentration levels and insight. CBT could be used in combination with other psychological interventions to ease the symptoms and psychosocial functioning, especially in young individuals at risk of psychosis or who have a dual illness and/or substance addiction. Although cognitive remediation concentrates on neurocognition and social cognition, there is the potential for synergy with CBT in enhancing the cognitive and social functioning of schizophrenia patients.
Social skills training strategy
Social skills refer to the behaviors or actions which when combined appropriately in a social context in a morally acceptable manner; enable a person to show social competence. People with schizophrenia lack social skills. It provokes tense interactions in social surroundings and may lead to isolation and withdrawal. Social skills training aims to improve patients’ social interactions about communication and interpersonal skills, community integration, illness management and fundamental activities of everyday life. It is centered on principles of behavior therapy and methods of teaching people to express their requests and emotions to meet their needs and achieve their goals. Since patients are trained in groups, it gives them an opportunity to get peer support and self-help as well as learning from each other’s experiences. Patients with schizophrenia are able to learn various social skills such as interpersonal and conversational skills, which are still present even after two years (Tan et al., 2018). Research reviews results also conclude that social skills training enhances social skills of patients and also helps to reduce relapse rates. Therefore, this intervention is highly effective in the recovery process of patients.
Personal Medicine strategy
Personal medicine refers to nonpharmaceutical activities that provided life meaning and purpose, as well as activities that helped to improve self-esteem, reduce symptoms, and avoid negative outcomes like hospitalization. This concept necessitates a shift in focus away from etiology and toward the complete person and elements that enhance wellness and well-being. Participating in socially valued roles (such as work), staying busy, getting exercise, activism, time with family members, physical intimacy, fishing, basic arithmetic, running errands, dietary changes, a good cry, being with “normal” individuals, being on there own, being in nature, speaking on the phone, taking a taxi ride, a day off work, pushing to accomplish, collecting dolls, or sunlight exposure are all examples of personal medicine. Personal medicine has been reported to alleviate anxiety, confusion, and other distressing symptoms. Clients found the term validated their experience and acknowledged that recovery requires hope, fortitude, imagination, and resilience among other qualities and attitudes. Personal medicine is not routinely reported to clinicians nor solicited by them.
Conclusion
Apart from pharmacological treatments which have been highly predominant, psychosocial treatments have also rapidly developed across many countries. Psychosocial interventions have significant effects on patients’ symptom control and prevention of relapse and hospitalization. Therefore, comprehensive care for schizophrenia patients comprises of both pharmaceutical treatment and also the provision of information, support, and rehabilitative therapies and interventions.
References
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González-Bueso, V., Santamaría, J. J., Fernández, D., Merino, L., Montero, E., Jiménez-Murcia, S., … & Ribas, J. (2018). Internet gaming disorder in adolescents: Personality, psychopathology and evaluation of a psychological intervention combined with parent psychoeducation. Frontiers in psychology, 9, 787. https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00787/full
Hersche, R., Roser, K., Weise, A., Michel, G., & Barbero, M. (2021). Fatigue self-management education in persons with disease-related fatigue: A comprehensive review of the effectiveness on fatigue and quality of life. Patient Education and Counseling. https://www.sciencedirect.com/science/article/pii/S073839912100625X
Tan, B. L., Lee, S. A., & Lee, J. (2018). Social cognitive interventions for people with schizophrenia: a systematic review. Asian Journal of Psychiatry, 35, 115-131. https://www.sciencedirect.com/science/article/pii/S1876201815300496
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