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Changes in persistent delusions in schizophrenia using guided self-determination: a single case study.

Rikke Jørgensen1, Lars Hansson Professor, Vibeke Zoffmann

  • 1Aalborg Psychiatric Hospital, Mølleparkvej, Aalborg, Denmark. rijo@rn.dk

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Summary

Guided Self-Determination (GSD) therapy helped a schizophrenia patient gain insight into his delusions. This six-week individual training fostered a shift from resistance to acceptance, improving his thought processes.

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Area of Science:

  • Psychiatry
  • Clinical Psychology
  • Mental Health Treatment

Background:

  • Schizophrenia treatment often struggles with patients who have limited insight into their delusions.
  • Existing treatment modalities have yielded mixed results for this specific challenge.

Observation:

  • A 55-year-old male diagnosed with schizophrenia participated in a six-week Guided Self-Determination (GSD) training.
  • The training focused on shared decision-making and problem-solving techniques.
  • Qualitative data, including reflection sheets and interview/field notes, were collected.

Findings:

  • The patient demonstrated a significant increase in insight into his delusions.
  • This insight developed through a distinct process: initial resistance, followed by receptiveness, then doubt, and finally, the adoption of a new cognitive framework.
  • The GSD method facilitated this internal shift.

Implications:

  • Guided Self-Determination may be an effective method for enhancing insight in schizophrenia patients with limited insight.
  • This approach could improve therapeutic outcomes by fostering patient engagement and self-awareness.
  • Further research into GSD's efficacy across diverse patient populations is warranted.