Inpatient psychosocial treatment of chronic schizophrenia: negative effects and current guidelines

In the inpatient psychosocial treatment of schizophrenia, therapies that are intense and overstimulating often promote or prolong regression and negatively affect long-term adjustment. These approaches fail to take into account the chronicity of the disorder, the special vulnerabilities of the schizophrenic patient, and the appropriate goals of an inpatient admission. Based on a review of these problems, the authors offer several prescriptions for inpatient psychotherapy of schizophrenia: modest, well-defined goals; gentle, supportive, educational interactions with the patient; inclusion of the patient's support system and outpatient caregivers in the treatment; and attention to long-term adjustment as well as to short-term symptom removal.