Psychotherapy with persons suffering from schizophrenia: the need for a new agenda

The success of the biological revolution in our understanding of schizophrenia, along with the lack of convincing evidence for the efficacy of global approaches to individual psychotherapy with schizophrenia, has led to the virtual disappearance of research and theory in this area. However, it seems timely to reexamine alternative approaches to psychotherapy that are based on an informed understanding of schizophrenia as a biological distortion of certain aspects of human experiencing. The purposes and unique role of psychotherapy within the broader range of treatments must be clarified, and more phenomenologically based, empirically tested problem-specific interventions developed. Three areas seem particularly suited for psychotherapy; (1) the human issues raised by having a chronic debilitating disorder that affects one's psychological experiencing, (2) attempts to help the patient manage the disorder, and (3) the normal psychological problems that persons with schizophrenia also face. Finally, suggestions are made about rethinking the therapeutic enterprise.