An empirical investigation of psychotherapy with schizophrenic patients

We examined the experience of schizophrenic patients who had been in psychotherapy for 1 year or longer. Therapists and their patients in a university-affiliated community mental health center were interviewed. One year later, followup interviews were conducted. Characteristics of participating patients, descriptions of therapy, behavioral changes, and relationships among these variables are reported. A comparison group of schizophrenics not in psychotherapy was interviewed once. The schizophrenic patients who maintain psychotherapies are isolated and quite impaired. Most patients and therapists report that psychotherapy helps; but there is little evidence of improved social functioning. Therapies that are associated with improved patient behavior are often conducted by more experienced therapists, and participants describe the therapeutic relationship in similar terms. Therapies without associated improvement are described in dissimilar terms by the participants. Results support the thesis that the process of psychotherapy with schizophrenics is related to outcome. Implications for training residents are discussed.