The Psychotherapy Of Schizophrenia

Inevitably, every psychotherapist has some experience with severely disturbed patients. Consequently, they will turn with excitement to this important new book which is a stunning attempt by two knowledgeable, persevering psychotherapists to present their understanding and sound therapeutic approach to these difficult and challenging patients. The authors argue that the treatment of choice is clearly psychotherapy and that such treatment can be successful and as long lasting for schizophrenic patients as it is for neurotic patients, but the journey may be longer and it may take more time to traverse.The task of therapy is to untangle the past from the present to make the future conceivable. The volume provides a thorough historical overview of the theoretical and clinical approaches to the problem of schizophrenia, including the views of leading contemporary clinicians on the topic. In general, the major clinical controversies have been regarded as issues of whether to focus on past, present or future; reality or fantasy; affects; exploration or relationship; whether the therapist should be active or passive; and how to handle regression. The authors argue that these are the wrong issues. They say that the task of therapy is to untangle the past from the present to make the future conceivable. Reality and fantasy are intertwined and must both be dealt with. Affects are central to all therapy, and emphasis on anger, despair, loneliness, terror, and shame are all necessary, as is the clarification of affect, and the acceptance of positive affect. Activity versus passivity is again in the wrong question; the right one is what action is helpful, when it is helpful, and when is not doing anything helpful? Regression is inevitable; should one accept it fully or try to limit it? This has no general answer other than do what is necessary (i.e., unavoidable) or most helpful to a particular patient at a particular time.

This volume is dedicated to Theodore Lidz and Ruth W. Lidz, as was the conference on the Psychotherapy of Schizophrenia held on April 9 and 10, 1979, at which the materials here published were presented. This 1979 sym posium replicated in some respects the one held at Yale University thirty years earlier, at a time when psychotherapy with schizophrenic patients was viewed with much optimism and enthusiasm. Ruth and Ted Lidz contributed to this earlier symposium also, emphasizing in their paper the intense mother-patient bond as a therapeutic issue. Since then, considerable strides have been made in the treatment of schizophrenic patients. The introduction of psychopharmacologic agents, the development of family therapy, and more sophisticated methods in com munity-based care for such patients, all have had important impacts. Psychotherapy with schizophrenics as such has remained a rather limited practice, partly because it is difficult and demanding of therapists' time and personal investment, and partly because documenting its effectiveness on a statistically or epidemiologically valid plane has eluded us.

In this unique book, Andrew Lotterman describes a creative approach to the psychotherapy of people diagnosed with schizophrenia and other forms of psychosis. Lotterman focuses on specific techniques that can be used in psychological therapy with people who have symptoms such as hallucinations, delusions, paranoia, ideas of reference, looseness of association and pressured speech. Formerly titled Specific Techniques for the Psychotherapy of Schizophrenic Patients, this edition updates research on the biology and psychology of psychosis and explores the many controversial issues surrounding diagnosis. It also includes two new chapters on the psychology and treatment of paranoia and on the experience of having a shattered self and the delusion of being the Messiah. Lotterman’s innovative approach aims to help patients with one of the most debilitating symptoms of psychosis: the collapse of language use. By restoring language as a way of communicating the patient’s meaningful inner life to himself and to others, the patient is then able to undertake a more traditional form of verbal psychotherapy. The book presents detailed case histories of patients who have benefited from this method, highlighting the specific techniques used and the psychological improvements that followed. The approach presented here complements medication-based treatments that have only had partial success, as well as other psychological approaches such as cognitive behavioural therapy, family therapy and social skills training. Psychotherapy for People Diagnosed with Schizophrenia will be a valuable text for clinicians working with people suffering from psychosis, including psychotherapists, psychoanalysts, psychologists, physicians and social workers. It will also be of great interest to academics and students.

Drawing on the authors' decades of influential work in the field, this highly practical volume presents an evidence-based cognitive therapy approach for clients with schizophrenia. Guidelines are provided for collaborative assessment and case formulation that enable the clinician to build a strong therapeutic relationship, establish reasonable goals, and tailor treatment to each client's needs. Described in thorough, step-by-step detail are effective techniques for working with delusional beliefs, voices, visions, thought disorders, and negative symptoms; integrating cognitive therapy with other forms of treatment; reducing relapse risks; and enhancing client motivation. Special features include reproducible client handouts and assessment tools.

In this innovative book, master clinician Michael Garrett shows how to weave together cognitive-behavioral therapy (CBT) and psychodynamic therapy to support the recovery of persons suffering from psychosis. This integrated framework builds on the strengths of both methods to achieve lasting gains, even for patients with severe, chronic mental illness. The therapist is guided to use CBT to help the patient recognize the literal falsity of delusions, while employing psychodynamic strategies to explore the figurative truth and personal meaning of psychotic symptoms. Extended case presentations and numerous clinical vignettes illustrate Garrett’s compassionate, empowering approach. Winner (Second Place)--American Journal of Nursing Book of the Year Award, Psychiatric and Mental Health Nursing Category

This book provides an unusually comprehensive survey of the current state and prospects of psychological methods of treatment for people with schizophrenia and other psychotic illnesses. It will be an invaluable resource for mental health professionals and clinical managers involved in their care, and essential reading for psychiatrists at all levels of experience. The three traditions of psychotherapy and integrated approaches are covered. Recent research in the process and outcome of psychotherapy is reviewed and summarised. Clear advice is also given on treatment techniques and settings with reference to national policies.

This book contains concrete and step by step information with many practical examples. It is in line with the most actual international empirical findings about schizophrenia and contains the most updated therapy approach being available currently. The techniques and exercises (partly computer-based) are described in detail. Case examples point out specific therapeutic situations and teach the therapist how to cope with complicated group and individual demands. Assessment for patient selection, differential indication and therapy control within a multi-dimensional treatment and rehabilitation system are discussed. INT was evaluated successfully in an international randomised multi-centre study. In the meantime it is implemented in many clinical settings in German speaking countries. Integrated Neurocognitive Therapy (INT) is a cognitive remediation therapy approach. INT is the first treatment manual comprising all MATRICS areas (Measurement and Treatment Research to Improve Cognition in Schizophrenia). The NIMH (National Institute of Mental Health, USA) initiated this MATRICS initiative. MATRICS defines 11 neurocognitive and social cognitive areas of functioning being relevant for patients with schizophrenia. The improvement of these areas in a group therapy is the main goal of INT. INT is based on IPT (Integrated Psychological Therapy, Roder et al 2010). It is a resource and a recovery oriented intervention to enhance also therapy motivation and self-esteem and to reduce negative symptoms. Therapy focuses especially on group processes and the exercises augment transfer and generalisation to daily life. As a meta goal INT intends to amend life quality and the reintegration of the patients in the community. The presented manual offers the clinicians a practically orientated guide for carrying out INT.

Art, Psychotherapy and Psychosis reveals the unique role of art therapy in the treatment of psychosis. Illustrating their contributions with clinical material and artwork created by clients, experienced practitioners describe their work in a variety of settings. Writing from different theoretical standpoints they reflect the current creative diversity within the profession and its links with psychotherapy, psychoanalysis, analytical psychology and psychiatry. In part I specific issues involved in working with psychosis are explored. These include discussion of the therapeutic relationship, the process of symbolisation, the nature and meaning of art made by psychotic patients and the interplay between words and pictures. Part II recounts the history of art therapy and psychosis, tracing its origins in art, to its present-day role as a respected treatment in psychiatric, community and therapeutic settings. Art, Psychotherapy and Psychosis extends the existing theory, develops analytical approaches in art psychotherapy and offers innovative perspectives for students and practitioners on the treatment of borderline states as well as psychosis.