Psychosocial treatments are forms of therapy including psychotherapy, social education, and vocational training. They’re sometimes used to treat people with mild, moderate, or severe mental illnesses, including schizophrenia. Most of the time, these treatments are used in combination with antipsychotic medication (also known as pharmacotherapy) to treat multiple elements of the disease, improve schizophrenia symptoms, and boost the well-being and quality of life of people living with the condition.
Schizophrenia and related psychotic disorders affect approximately 1 percent of the U.S. population — 3.2 million people — according to the National Institute of Mental Health.
There’s no cure for schizophrenia, so treatment focuses on controlling symptoms. Antipsychotics have been widely tested and used in the treatment of schizophrenia for many years.
Even though antipsychotic medications work, most people with schizophrenia still have signs and symptoms like:
When added to antipsychotic drugs, psychosocial treatments can help with these problems.
There are various forms of psychological treatment, and some people respond better to one type of therapy than another. To figure out which may work best for a particular person, a psychotherapist will consider factors including their personality and the nature of the issues they’re working on.
Cognitive behavioral therapy (CBT) is a type of psychotherapy that focuses on changing harmful or negative ways of thinking and acting. CBT helps people understand and change their thinking when they are having strange or confusing thoughts and experiences. This helps them feel better and understand what is really true.
CBT is a relatively short-term treatment, usually lasting six to 20 sessions. Sessions usually occur weekly or every two weeks and last 30 minutes to an hour. CBT has been shown to be effective in treating a range of mental health conditions, including anxiety, depression, and schizophrenia.
CBT is usually part of a comprehensive treatment plan that also includes medication and other psychological treatments. It is usually done one-on-one with a mental health professional, such as a therapist, psychiatrist, or psychologist.
In the past 10 years, there’s been a growing interest in using CBT techniques to help people with schizophrenia — especially those who still have psychotic symptoms despite getting the best possible drug treatment.
In people with schizophrenia, the main goals of CBT are to decrease the severity of psychosis, delusions, and hallucinations (collectively known as positive symptoms) and to equip the person to take an active role in reducing their risk of relapse and level of social disability (known as negative symptoms).
Family therapy (also known as family intervention) includes both the person with schizophrenia and their family members. The goal of this therapy is to help family members better understand and support the person with schizophrenia. Family therapy also aims to improve communication and deepen connections among family members and make life easier for everyone.
The therapy usually involves group sessions with a therapist, where family members can talk about and work through any problems they may be having, such as caregiving for the person with schizophrenia, managing their symptoms, and dealing with the stress of the illness.
Social skills training (SST) focuses on helping a person improve their social functioning and interactions with others. Through SST, a person learns to improve their social interaction abilities, such as their capacity for meaningful conversation, healthy emotional expression, and creative problem-solving.
SST can be done individually, with family members, or in a group setting — but the group approach is the most common. Groups of people living with schizophrenia — usually four to 12 — meet regularly with one or two therapists during which they learn and improve social abilities. The therapist may employ strategies such as leading role-playing exercises and showing video examples to help participants develop and improve their skills.
Though research is limited, studies have found that SST may improve quality of life for people living with schizophrenia by helping them to create more meaningful relationships with loved ones and encouraging them to be more independent. It also may help reduce symptoms like paranoia and delusions.
Vocational rehabilitation helps people with disabilities or serious health issues, such as schizophrenia, prepare for, find, and maintain employment. The goal of vocational rehabilitation is to help people with schizophrenia work and live productive, independent lives.
Vocational rehabilitation services may include:
Vocational rehabilitation can also provide support in areas such as resume building, interview preparation, and job search strategies.
Case management is a coordinated way to help people with complex health needs get the services and support they need to manage their condition and improve their quality of life.
People with schizophrenia usually start the case-management process with an evaluation of their needs and a review of their medical history. This information allows the case manager to make a personalized care plan, which includes a list of recommended services and support.
Then, the case manager works with the person with schizophrenia and their health care providers to make sure they get the help and services they need. This could mean putting the person in touch with health care providers, community resources, or social services.
Psychodynamic therapy is talk therapy that looks at unresolved conflicts and events from a person’s early childhood that may have led to current mental health disorders. The therapy is based on the idea that a person’s subconscious thoughts and their past experiences can affect their current thoughts, feelings, and actions.
Through this form of therapy, people with schizophrenia can learn to better understand their symptoms, experiences, and feelings. This can lead to better control over the symptoms of schizophrenia.
Importantly, psychodynamic therapy is usually used along with pharmacological treatment and other forms of treatment. This is because schizophrenia is a complex condition that needs more than one treatment program to manage it.
Psychodynamic therapy should be conducted by a mental health professional who has worked with people with schizophrenia before.
Peer support therapy is a type of psychosocial treatment for people with schizophrenia that involves talking to and getting help from other people who’ve been through similar mental health issues. There are many kinds of peer support therapy, such as:
Peer support therapy can help individuals with schizophrenia develop coping skills and better manage their symptoms. Research has shown that peer support therapy can lead to improved recovery outcomes, such as a better quality of life and reduced hospitalization rates.
Like all treatments, psychosocial interventions for schizophrenia can have some side effects. However, these side effects are typically mild and short-lived. Some of the common side effects of psychosocial treatments for schizophrenia include:
It’s important to remember that these side effects are usually mild and temporary and that the benefits of psychosocial treatments for schizophrenia can outweigh any temporary discomfort. If you try one of these treatments and experience any severe or persistent side effects, you should talk to your therapist or doctor to determine the best course of action.
Everyone’s experience with schizophrenia is different, and some forms of psychosocial treatment may be a better fit for one person than another. Work with your doctor or therapist to develop a complete treatment plan that fits your wants and needs.
You can check with your local community mental health center or your doctor’s office to find out what psychosocial services are available in your area. Some treatments may be covered by your insurance plan. Some providers also offer services on a sliding scale.
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