Integrated Psychotherapy And Schizophrenia

We currently have a number of different methods of psychological intervention when it comes to the treatment of. These forms of intervention have taken an unusual direction in recent years. A new method called integrated psychotherapy (IPT) has emerged in the field. But what is it really and what is this treatment about?

In recent years, the above interventions have been dominated by a pessimistic and highly organized vision of psychiatry and psychiatric treatment, represented by Kraeplin’s psychoanalysis . Among other things, he considered dementia to be a narcissistic neurosis where transmission and analytical treatment were not possible.

A change in psychological treatments

As a result, there has been a change in therapeutic care and treatment. Initially, the focus was only on the treatment of schizophrenia itself, or on the rehabilitation of patients after a deterioration in their condition. Now, however, a number of therapies have also begun to treat the symptoms. One of the treatments is Roder and Brenner’s integrated psychotherapy (IPT) for schizophrenia.

The most important advances in the treatment of schizophrenia have been developed and refined on the basis of a vulnerability-stress model. This is a framework that shows how various external stressors interact with biological vulnerability.

We can begin with the assumption that people with schizophrenic disorders show signs of weaknesses and deficiencies at several different levels of their behavior. These levels are; intentional-observation, cognitive, microsocial and macrosocial. Deficiencies at one level can have a negative impact on the others, which indicates a certain hierarchical relationship between the various levels. And it is on the basis of this hypothesis that Brenner and his colleagues have developed the penetration model.

This has served as a basis for explaining the symptoms of schizophrenia and for developing integrated psychotherapy. From this point, we have been able to witness how changes at a cognitive level have a direct impact on a person’s behavior.

Integrated psychotherapy for schizophrenia and its main characteristics

This treatment is used in a group format with between 5 and 7 patients. Experts have specially developed this form of therapy for people with a schizophrenic disorder. The goal of therapy is to improve the patient’s cognitive and social skills. The treatment lasts between 30 and 60 minutes and takes place three times a week over a period of three months.

The treatment is ideal for patients who are:

• between 18 and 40 years old
• do not use narcotics or take strong medications (in which case only occasionally)
• a person living with the family

• a person who has not spent too much time in hospital
• a person who has a mild to moderate forehead disorder

Experts have tried this form of treatment on over 700 patients in various socio-cultural contexts. The results confirm that it really is an effective form of therapy (from a psychological perspective) for the treatment of symptoms of schizophrenia.

The five sub-programs

Integrated psychotherapy for schizophrenia consists of five sub-programs. Through these programs, efforts are made to improve the cognitive disorders and deficiencies in social skills and behaviors that are so characteristic of this disorder. These programs are hierarchically ranked in the following order.

• The first stages are aimed at basic cognitive skills.
• The intermediate stages transform the cognitive skills into verbal and social responses.

• In the latest programs, the patient is trained to solve the more complex, interpersonal problems.

Each program is designed so that as the therapy develops, more and more is expected of the patient. Progress is made by starting with simple and predictable tasks and then becoming more difficult and complex over time.

At the same time, there is a gradual dissolution of the structure itself in the treatment. In the beginning, the treatment has a very structured approach that gradually becomes looser and more spontaneous. Each program also starts with material that does not require too much emotional empathy. In addition to the treatment, the therapist slowly increases the emotional burden.

The therapeutic sub-programs in the treatment of schizophrenia

The following is a presentation of the five sub-programs that are used in integrated psychotherapy:

• Cognitive differentiation. This focuses primarily on skills related to mindfulness and concept formation. To implement this program, the therapist will use cards and exercises where verbal concepts are one of the main techniques in the treatment. This is followed by a discussion of the significance of the various situations.
• Social perceptions. Here, the goal is the actual analysis of social stimuli. To achieve this, the therapist will use a description of social stimulation and then interpret this stimulation.
• Verbal communication. The therapist trains the patient’s conversational skills here. This is done by using verbal repetitions, analogies, questions and discussions around specific topics as well as general conversations.
• Social skills. This sub-program focuses on the patient’s social competence, a very important topic for people with schizophrenia. By using role-playing games, among other things, you work your way through several different social situations.

• Interpersonal problem solving. Patients learn here how to use problem-solving techniques in their own relationships. The techniques used are; the identification and analysis of problems, cognitive restructuring and the application of these solutions in one’s own life.

The first of the sub-programs aimed at cognitive differentiation improves the elementary cognitive processes in patients. Examples of this are the ability to focus and maintain attention, as well as sharing ideas. At this point, however, the results will be below normal levels.

The effects of integrated psychotherapy

To date, there are insufficient data available to confirm the effectiveness of the penetration hypothesis in integrated psychotherapy for schizophrenia. For the effects on cognitive variables do not always produce consistent and steady improvements in a person’s behavior.

The ability to process information correctly is very important, but it is not all that is needed to be able to create what we call “normal” behavior.

It is possible that changing factors such as self-image can act as an obstacle to the penetration model. Nevertheless, other studies have discovered that it can also work in the opposite direction.

If we start with social rehabilitation, it is possible to initiate a more significant declining effect aimed at basic cognitive functions. This will then activate coping abilities, develop non-impaired cognitive processes and improve self-esteem.

Within the field of integrated psychotherapy, there are now a number of new programs and forms of treatment. One of these programs is training in emotional coping. Here, the goal is to reduce the impact dysfunctional emotional states have on cognitive and social functions.

Experts have also developed a training program for qualities you need both in your free time and at work. They have developed these programs to facilitate a generalization of the abilities they have developed during therapy. The goal is for them to be able to create coping skills based on psychological education programs. The goal is also to change the way we handle and look at patients with schizophrenia.