Psychosocial therapy is mainly used in cases of people with schizophrenia . This therapy seeks the rehabilitation and reintegration of the person with mental disorder into society. It focuses on strengthening the empathy of the patient and on promoting different types of skills (social, communicative…).
In addition, it also takes into account the family, and part of an integrative view, which allows to understand the subject in its totality. In this article we will know its characteristics, the techniques it uses, the objectives it pursues and how it can help people affected by schizophrenia.
Psychosocial therapy: characteristics
Psychosocial therapy is a type of therapy especially indicated for patients with a schizophrenic disorder. It starts from a holistic vision of the person, understanding that the disorder is born from a series of multifactorial causes , and where the genetic component also has an important weight.
This type of therapy, also called psychosocial and occupational rehabilitation, seeks above all to reintegrate the person with mental disorder into society . It is usually developed by an interdisciplinary team of mental health professionals (primary care physicians, psychiatrists, clinical psychologists…). As for its theoretical foundations, it is based on a vulnerability-stress model.
This model of vulnerability-stress maintains that, in mental disorders, there is a previous vulnerability (biological, social…) in the person, but also a series of external events that, “in contact” with this vulnerability, trigger the symptoms.
Applied to the case of schizophrenia, there would be a series of triggering (stressful) and external factors in the subject’s environment that would trigger or originate the psychotic break; this would occur because there is a previous personal vulnerability in the patient .
Treatments in Schizophrenia
There are different types of psychological treatments for schizophrenia. We can classify them in four big blocks: the interventions oriented to the organization of the assistance (where we would find the psychosocial therapy); the group interventions on cognitive variables, social cognition and social skills (HHSS); the psychoeducational group interventions, and the cognitive-behavioral packages (individual approach).
Within each of these blocks, we would find different therapies indicated for patients with a schizophrenic disorder. In turn, s there are different degrees of effectiveness of the therapies, according to the reference manuals (effective, probably effective and experimental therapies). Psychosocial therapy, in particular, has been shown to be effective in the treatment of schizophrenia. This means that various controlled studies have been carried out to support its effectiveness.
The psychosocial therapy or psychosocial rehabilitation, establishes a series of objectives that can be personalized and adapted to each case. These are, fundamentally:
1. Acquire or regain skills
These skills can be of different types: social skills (facilitating interactions with others), cognitive skills, coping with stress, frustration tolerance, etc.
2. Promoting social integration
The achievement of social integration is also related to the promotion of autonomous functioning in the patient . That is, both concepts go hand in hand; the integration of the patient into society (with a circle of friends, a family network involved, a job…) will favour the autonomy of the patient, and vice versa.
3. Preventing deterioration
The prevention of patient deterioration is also achieved through the prevention of their marginalisation and institutionalisation.
4. Occupational rehabilitation
This objective is related to sheltered employment (protected labour market). Within it, we find the CET (Special Work Centres) or CEE (Special Employment Centres), where people with a minimum degree of disability of 33% can work. In this case, persons with schizophrenia could incorporate themselves into the labour market , performing an adapted job, the closest thing to an ordinary job.
5. Advising and supporting families
Families of people with schizophrenia also suffer greatly from their loved one’s disorder, especially families who are heavily involved.
That is why psychosocial therapy, in addition to providing guidelines and psychological care, aims to help families learn to identify the warning signs of a possible psychotic break in their family member (son, brother, cousin…). This will be important in order to anticipate and be able to act sooner, by going to a medical professional.
What is the purpose of psychosocial therapy?
Psychosocial therapy for schizophrenia has as its fundamental objective the psychosocial rehabilitation of the person, and his or her integration into the community. This means that seeks to free the patient from the social stigmatizations that surround the fact of suffering from a mental disorder , and to be able to make a life as “normal” and autonomous as possible, with their human rights preserved and a good quality of life.
On the other hand, this type of therapy, as we indicated at the beginning, is very focused on the emotions and their perception ; that is, it aims to help the patient learn to identify the different emotions, and the situations that provoke them.
It also seeks to enable the patient to understand not only himself but also others. In other words, he or she should be able to correctly interpret social situations, body gestures, other people’s words, etc. All these elements and objectives, according to the psychosocial therapy, will increase the quality of life of the patient, and will facilitate his social integration.
The ultimate goal is for the subject to “adapt” to the mental disorder and learn to live with it.
The techniques and strategies used in psychosocial therapy are based, above all, on promoting the empathy of the patient through tools and tasks that allow working on the recognition of emotions.
In order to work on empathy, the therapy focuses on the well-known theory of mind , a capacity that explains the fact that we can put ourselves in the other’s place, and that we can understand that there are mental states (and thoughts, reflections, opinions…) in other people’s minds, different from our own.
On the other hand, in psychosocial therapy some communication techniques are also used, with the objective that the patient learns to communicate effectively and assertively , respecting the other and respecting himself/herself. These techniques, therefore, promote healthy communication and the correct expression of emotions.
Psychosocial therapy also includes behavioural and cognitive techniques (which we will see later on). The behavioral techniques, in addition to working on the patient’s inappropriate behaviors, and enhancing the patient’s adaptive behaviors, are especially aimed at promoting and enhancing the patient’s adherence to pharmacological treatment.
The pharmacological treatment (which are usually antipsychotics) in the case of schizophrenia, as well as in all mental disorders, is of vital importance for the patient to be able to lead as normal a life as possible.
In addition, drugs can significantly reduce and alleviate a patient’s symptoms, helping the patient recover from a psychotic break. That is, the psychopharmacological treatment in this case is a basic treatment, essential, which allows us to work with the patient at other levels (social, work, psychological …).
Without a correct medical prescription (i.e. treatment appropriate to the needs and profile of the patient) and correct adherence to pharmacological treatment by the patient, psychosocial therapy cannot “act”.
On the other hand, cognitive techniques, which can also be used in psychosocial therapy (although it is not so common), are focused on reducing the distorted thoughts of reality that disturb the patient .
It is true, however, that to treat delusions and hallucinations, for example, as well as paranoid thoughts, a therapy within the cognitive-behavioral block for schizophrenia (discussed at the beginning) is more indicated.
This is because psychosocial therapy, in reality, is more focused on rehabilitating and reintegrating the patient into society; for this purpose, however, it is true that it is important that both the positive and negative symptoms of schizophrenia are controlled .
Thus, we are seeing how psychosocial therapy starts from an integrative approach, which aims to maintain a holistic view of the disorder and the person who suffers it. That is why it is nourished by strategies and tools from different fields and theoretical orientations within psychology.
- Horse (2002). Manual for the cognitive-behavioral treatment of psychological disorders. Vol. 1 and 2. Madrid. Siglo XXI.
- Montaño, L., Nieto, T. and Mayorga, N. (2013). Schizophrenia and psychological treatments: a theoretical review. Revista Vanguardia Psicológica, Clínica Teórica y Práctica, 4(1): 86-107.
- Pérez, M., Fernández, J.R., Fernández, C. and Amigo, I. (2010). Guide to effective psychological treatments I and II:. Madrid: Pirámide.