[Psychological therapy of patients with schizophrenia: Trend of the concept development]

Abstract

In the first stage of the application of behavioral methods the improvement of the level of function in the social environment was in the lime-light. In the single case the restoration of a structured daily routine represents the presupposition for a cognitive therapy. Its aim is the building up of intrapsychic controlling processes that support the structuring of embarrassing experiences. E.g., it is possible by controlled introspection to identify stressors, perceived by the patients themselves, leading to overstrain-reactions. The reduced capacity to be subjected to stress has to be made understandable to the patient who is encouraged to intentionally use avoiding reactions. By the insight in such connections the problem is comprehended and the anxiety reduced. In the psychoeducation the instruction of the family members about basic symptoms proved to be useful to put the behavior of the patients in the right place and to correct misunderstandings. A skeleton-concept is needed, containing many individual components that can be variably used. The completion of these components is the aim, because the very heterogeneous features of the residual syndromes of schizophrenic disorders require such an "open concept".