Introduction
Schizophrenia virtually characterizes a disintegration of the thinking process as a mental illness disorder. The emotional disintegration aspect of the condition has necessitated many therapeutic techniques in managing the condition. Common manifestation symptoms of the conditions are strange delusions, paranoia, auditory hallucinations, and other types of dysfunctions that may either be occupational or social. The diagnosis of this condition is developed from the patient’s experiences because there have been no laboratory tests developed to effectively diagnose the condition (Amminger, 2006).
Many approaches have been developed to explain this condition, with most researches pointing out that genetics, primary environment, neurobiological and psychological processes have a big role to play in it. Current research studies have shifted the analysis to a neurobiological point of view though no specific organic component has been identified as a cause of the condition. Consequently, there has been debate regarding the symptoms of the disease depending on whether they represent one condition or multiple disorders (Kirkbride, 2006).
Schizophrenia has been majorly identified in the mesolimbic pathway of the brain, evidenced by increased dopamine activity. This condition has been traditionally thought to affect cognition but studies have shown that chronic problems especially associated with emotions and behaviors are also affected. Patients suffering from schizophrenia are therefore bound to have comorbid conditions which are characterized by severe anxiety and depression disorders (Jansson, 2007). This study will address schizophrenia in the context of therapeutic techniques used to manage it, along with the influence of stigma on the treatment.
Problem Statement
The treatment of schizophrenia is important because society and different cultures still stigmatize patients. Schizophrenia had in the past never been a common psychological disorder though its prevalence in society today has greatly increased. There is therefore a higher population suffering from the condition today than in the past. As a result, there is a huge population in society who are wrongly being stigmatized by society because of this condition. This implies that management methods need to be improved to make such patients more acceptable in society by trying to suppress the condition as much as possible (Kirkbride, 2007).
The level of social stigma associated with this condition has been identified as a major obstacle to the recovery of patients from this condition. Studies were done in 2005 report that a significant proportion of the American population of about 12.8% believe that patients suffering from schizophrenia are more violent than normal people while another representative group of about 48.1% thought that patients were “very likely” to commit a violent act (Fitzgerald, 2005). More than 74% of the respondents thought that schizophrenic patients were not in a position to make rational decisions about their treatment. An almost proportionate group of respondents also identified money management as a problematic issue concerning treatment.
According to available meta-analysis, the negative perception of patients suffering from psychosis has more than doubled in recent decades (Malhi, 2008). Due to the stigma the society has towards patients suffering from schizophrenia, the Japanese Society of Psychiatry and neurology changed the term “split minded disorder” to “integral disorder” (Malhi, 2008). The biopsychosocial model was the biggest inspiration to the coining of this term and consequently led to increased awareness regarding this condition from 36.7% to 69.7% in only three years (Davidson, 2008). Films have also been made in west India, for example, to show the behaviors, mentality and social struggles patients suffering from schizophrenia have to undergo in their day-to-day lives, due to stigmatization in society. Other factual books such as Tell me I’m hereby Anne Deveson and The Master and Margarita by Ivan Bezdomnyj have also been written to show the struggles schizophrenic patients have to endure (Malhi, 2008). There is therefore a pressing need to manage this condition so that patients can live a close to normal life to avoid the stigmatization and misinformation that exists in society (Jakobsen, 2005).
Through this analysis, it will be easier to establish the existent management methods that can be used to suppress this condition to enable the patients to live a more fulfilling and normal life. A lack of these managerial treatments increases the severity of the condition and may even lead to further deterioration of the patient’s health (Peters, 2005). An evaluation of the therapeutic management of this condition will therefore make patients choose from existent optional methods to suppress this condition and hence live a more fulfilling life. In turn, the stigma associated with this condition will decrease because patients will be able to live a fulfilling life just like any other person.
It is important to do this because the life expectancy associated with schizophrenic patients has tremendously decreased because of the physical harm they predispose themselves to (Becker, 2006). About five percent of patients suffering from this condition have also committed suicide due to the level of stigmatization coming from society. This rate will be decreased if not done away with because patients will have a new sense of life rejuvenation because of more fulfilling methods of managing the condition.
Therapeutic Techniques
The concept of devising a form of cure has remained elusive and controversial in past decades. A criterion for the remission of the symptoms has however been recommended as the best way to go about managing the condition. Treatment methods available are primarily based on standardized procedures which are most commonly the positive and negative syndrome scales. The management of this condition has in the past proved to be more achievable than trying to devise a cure for the condition (Lake, 2007).
A recovery model is primarily being used to provide hope, empowerment, and inclusion into society but hospitalization has been proposed as a method of managing the condition when it becomes chronic. This can either be done voluntarily or not. Nevertheless, instances, where patients have been hospitalized for a long, have tremendously reduced due to deinstitutionalization. However, this doesn’t mean such situations cannot be encountered. Instead of hospitalization, community support should be encouraged especially from close family members to facilitate the patient’s recovery (Sim, 2006).
In less developed countries, patients suffering from schizophrenia have been traditionally treated from a community point of view only; which is a more informal type of treatment. Consequently, repeated surveys from international health bodies have indicated that the treatment of patients in non-Western countries has been more effective than in the western world (Mashour, 2005). Many researchers have therefore concluded that the condition has a more social connection than was previously thought.
This has led to the development of therapy as an integral component in the management of schizophrenia. Psychotherapy has been especially common in the management of this condition although its applicability may be confined to pharmacotherapy because of the problems associated with reimbursements or a sheer lack of training of medical personnel (Mashour, 2005).
Cognitive-behavioral therapy has also been advanced in the treatment of specific symptoms associated with the condition. In addition, it has been effectively used to improve self-esteem, social functioning and is most often insightful to the patients. However, the results related to early trials of this therapy method have been inconclusive. Nevertheless, medical research undertaken in 2010 has identified that no trial that employs both blinding and psychological playplacebos has established that cognitive behaviors therapy can be used in reducing the episodes associated with the condition or reducing a resurge of its symptoms (Mashour, 2005).
Another common approach used in therapy is cognitive remediation which primarily aims at remediating the cognitive neuro-cognitive deficits that are common with the condition (Palmer, 2005). Neuropsychological rehabilitation has been proof that this method can be effective in cognitive brain stimulation. An almost similar method identified as cognitive enhancement therapy has also shown the same level of efficacy because it aims at improving social cognition as well as improving the neuro-condition.
Family therapy and education which targets the family unit have also been advanced as a viable therapeutic method that can be used to manage the condition. However, this method has been proved to be most effective when the treatment is long-term (Liberman, 2005). The availability of information regarding this method has contributed to its popularity, but there has been evidence that social skill training has improved the efficacy of therapy though there are negative findings that have become significant setbacks in its applicability.
There have also been voices made in the field of psychology to include the use of music therapy and other forms of creative therapy to supplement therapeutic procedures. The Soteria model; has also been advanced as an alternative form of treatment to hospitalization but with the incorporation of minimal medication (Mullen, 2006). This method is often referred to as a milieu therapeutic recovery method. This was coined by its founder, terming it around the clock application of interpersonal therapeutic method which could be overseen by non-medical staff. This is especially possible because it does not incorporate neuroleptic drug treatment and is often done in the context of a home environment that is quiet, supportive, protective, and tolerant.. Despite the scarcity of research information, studies done in 2008 have pointed out that this type of therapy is equally effective to the medication given to patients who have just experienced their first or second episodes of schizophrenia (Malhi, 2008).
Electroconvulsive treatment has also been advanced as a possible method of treatment when all other therapeutic methods have failed. This type of therapeutic treatment is therefore not a first-line method of treatment and is used under specific guidelines. Psychosurgery has also become an unpopular method of treatment but service user methods have become an integral part of the recovery process especially in Europe and the United States (Mashour, 2005).
At the forefront have been groups such as the Hearing voices network and the Paranoia network that have been a deviation from the traditional methods of treatment to provide support and assistance to patients. These groups have also tried to differentiate personal experiences with mental illness or health and have instead destigmatized the patient experience and encouraged personal responsibility, along with the development of a positive self-image (Nordgaard, 2008). There have also been signs of a surge in partnerships between health facilities and consumer-run groups with an emphasis on remediating withdrawal from society, improving social skills, and reducing the chances of multiple hospitalizations. Constant exercising has also been recommended as a viable method for schizophrenic treatment.
Conclusion
Therapy has been an effective method in managing schizophrenia. It has been especially important because most patients have been stigmatized from having this disease with the general public being of the opinion that schizophrenic patients are likely to be more violent than people who don’t suffer the condition. In this regard, patients have been stigmatized, with some resorting to committing suicide whereas a greater majority has been noted to have a lower life expectancy. Therapy has therefore been proved to be a viable tool in managing schizophrenia. Therapy has also been identified to reduce the impact of negative societal impacts on patients with schizophrenia. It is also aimed at improving the chances of recovery for their patients. Many therapeutic methods exist, though consideration has to be made on their efficiencies.
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