Integrated rehabilitation in schizophrenia. Development of treatment methods and presentation of some results

The embryo to our integrated treatment programme was "combination treatment in schizophrenia". This combination treatment included behavioural therapy, psychotropic drugs and dynamic psychotherapy. It was also integrated with work therapy and sociotherapy. A number of prospective and retrospective studies for the development work are exemplified. The method of development and method descriptions for above all the psychotherapeutic work are presented. During the years most of the patients have been treated either by D. Lindberg (psychologist) or U. Malm (physician) under the medical responsibility of the head of the department (S.J. Dencker, M.D.). The resulting "integrated treatment programme" is described. The treatment comprises depot neuroleptics in combination with psychosocial measures during a time of two years. During this period the contributions of a head therapist, usually a specially trained psychologist or physician, are coordinated. After a diagnostic phase, including international rating scales and special record keeping, comprising 1--2 weeks, a medical adjustment time and a contact establishing period follows for about 1 month. When the patient is able to stay in an open ward a three months integrated treatment programme in hospital is started. In hospital the patients are either offered group psychotherapy 4 times a week (the "country model") or once a week (the "big city model") in combination with depot neuroleptics and other planned psychosocial methods. Our experiences from a treatment with integrated treatment programme point at the fact that patients with some form of schizophrenic state can live in the society "with a good quality of life". Methods and evaluations of the continued rehabilitation measures are proceeded and like Hogarty et al. (1976) we are looking for new roads.