- Systemic approach: The sources consistently emphasize the importance of a systemic approach to therapy. This means that not only the person affected, but the entire family system is included in the therapy process. The family is considered a dynamic system in which a person’s problems are often related to the family’s relationship structures and communication patterns.
- Resource orientation: Therapy should be resource-oriented and make use of the family’s strengths and abilities. Parents are seen as resources and not as obstacles.
- Relationship orientation: The therapeutic relationship is of central importance. A fearful or overprotective attitude on the part of the therapist can have a negative impact on the course of therapy. A confident and attentive attitude is helpful.
- Learning process: Therapy is considered a learning process for everyone involved, including the therapists. Mistakes are seen as part of the learning process.
- Multidirectional partiality: Therapists should adopt an attitude of multidirectional partiality, i.e. they should empathize with all family members and recognize their respective points of view.
- Patience and time: There is no quick fix for schizophrenia; therapy is a long-term process. Changes take time and patience.
Specific therapeutic approaches
- Family therapy:
- Genogram work: A genogram analysis of at least three generations is an important tool for understanding family entanglements and dysfunctional relationships.
- Observation of interaction patterns: The communication patterns and interactions within the family are observed to identify dysfunctional patterns.
- Identification of patterns: The therapy aims to identify and change recurring patterns and behaviors.
- Processing unresolved conflicts: Unresolved conflicts in the family, especially between the parents, are addressed.
- Parents as key players: Parents are central actors in the change process. Changes in the behavior of parents have a positive effect on the entire family.
- Therapy with parents:
- Parents‘ feelings of guilt: The feelings of guilt of the parents are acknowledged, as these often cause resistance to change.
- Parents as a team: Parents are encouraged to work together as a team and to respect their different parenting styles.
- Working on personal issues: Parents are encouraged to deal with their own family of origin, as this is an important step towards change.
- Relief: Parents are supported in therapy to free them from entanglements with their children.
- Dealing with the patient:
- Understanding symptoms: Symptoms are not only seen as symptoms of illness, but also as an expression of conflicts in the family system.
- Their own reality: The own reality of the patient is recognized.
- Strengthening personal responsibility: The goal is to get the patient out of his role as a “diplomatic mediator” between the parents and to encourage personal responsibility.
- Activation: The patient is actively involved in therapy to initiate change processes.
- Communication therapy:
- Direct communication: The family is encouraged to communicate with each other directly and openly, instead of indirectly or evasively.
- Addressing conflicts: Conflicts should not be avoided, but addressed.
- Mindful listening: Therapy promotes mindful listening and a better understanding of each other’s perspectives.
- Vocational rehabilitation:
- Support with job searches: Patients are supported in their career choice and job search.
- Job coaching: Job coaching as an alternative method can be a great help.
- Resource orientation: The patient’s talents and abilities are taken into account in vocational rehabilitation.
Important aspects of the therapy process
- Resistance: Resistance to therapeutic interventions is seen as natural self-protection.
- No compulsion: Therapy should not be forced upon anyone. Parents and patients must be willing to engage in the process.
- Flexibility: Therapists should respond flexibly to the needs of the family and adapt the therapy process accordingly.
- Criticism as feedback: Criticism of the therapy is seen as valuable feedback that can be used to improve the therapy process.
- Emotional calming: In the first step, it is important to calm the family’s emotional climate before attempting to correct irrational behavior.
- Active participation of parents: The active participation of parents is crucial, as they have an important influence on the success of therapy.
Collaboration
- cooperation: A cooperative attitude between all parties involved is very important.
- Involvement of relevant persons: Important persons such as employers, teachers or other therapists are included in the therapy process.
- Trust: The parents‘ trust in the therapist must grow before changes can be made.
Additional remarks
- Psychotropic drugs: Psychotropic drugs can be used as a support, but should not be the only treatment. They should always be taken openly and not secretly.
- Dealing with anxiety: The therapeutic attitude should not be characterized by anxiety, as this can impair the success of the therapy.
In summary, it can be said that the therapeutic approaches to schizophrenia are diverse and based on a systemic understanding of the disease. Successful therapy requires close collaboration between therapists, patients and family members, a willingness to change and patience. The therapy aims to recognize and change dysfunctional patterns, activate resources and promote personal responsibility in those affected.
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