Cognitive Therapy Improves Schizophrenia

Psychological therapy helps schizophrenic patients recover dramatically

October 3, 2011 / Author:  / Reviewed by: Joseph V. Madia, MD

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(dailyRx News) For people who go through life struggling with schizophrenia, the idea of having a normal, functioning daily existence may seem out of reach. Traditionally, antipsychotic medication has been the primary means of treatment to reduce hallucinations and delusions.

But positive cognitive therapy is showing great potential in reducing symptoms and improving the quality of life for schizophrenic patients—who may have more potential than previously thought possible.

"Seek a therapist if concerned about schizophrenia."

Researchers from the Perelman School of Medicine at the University of Pennsylvania conducted a controlled study of 60 schizophrenic adults in Philadelphia. The patients were all given standard treatment, including antipsychotic medication, but half also received cognitive therapy.

The therapy intervention helped patients set concrete goals for daily living, and motivated them to engage in tasks that put them more in touch with society and moved them out of their withdrawn state. Therapy also targeted defeatist beliefs that previous research by lead authors Aaron Beck, MD, and Paul Grant, PhD, identified as blocks to patients' constructive behaviors.

After 18 months, the patients in the cognitive therapy group had made great improvements, in what researchers labeled a "dynamic cycle of recovery." Daily functioning and quality of life were significantly improved, and the physical symptoms of schizophrenia were also reduced, such as hallucinations and disorganized speech.

Russell J. Ricci, MD, says that such therapy provides a major step forward in helping patients improve the quality of their lives. "Rather than being stuck in the past, cognitive therapy's value lies in helping patients look forward and act positively."

According to Grant, mental health professionals often give up on patients with low-functioning schizophrenia, believing them incapable of improvements. But this study suggests that cognitive therapy can achieve results in these patients that would allow them to function far better. "This intervention can help these patients improve to the point where they may be able to move up to the next level in psychosocial functioning - i.e. going from being unemployed to volunteering part-time; not being in school to enrolling in night classes; not socializing to having a weekly social contact and making a friend or two," Grant says.

Between two and three million Americans suffer from schizophrenia, and one-third to one-half of those either can't tolerate antipsychotic medications or continue to experience symptoms even when medicated. Treatment costs are also high, and the possibility of such dramatic improvements through cognitive therapy may reduce public health costs and improve patients' quality of life.

Grant and Beck believe this study shows that schizophrenic patients have more potential than care providers or family members may think, and plan to train community therapists to delivery cognitive therapy in community mental health agencies. Their research findings will be published in the October 2011 issue of the Archives of General Psychiatry.