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    How Families Can Cope with Schizophrenia


    Medication and Job Counseling continued...

    While it is foolish to "push" schizophrenic individuals into high-pressure jobs for which they may not be ready, it is also unwise to assume that schizophrenia amounts to a permanent disability. Many individuals with this illness can rejoin the workforce, with appropriate vocational rehabilitation and lots of emotional support.

    In fact, a recent study by Dr. R.E. Drake and colleagues at Dartmouth Medical School found that many patients get into the job market faster than was once thought. Rather than getting "stalled" in the usual sheltered workshops, the patients in this study were able to secure competitive jobs quite rapidly, and hold these jobs. This was probably because the patients received ongoing counseling, transportation assistance and help in dealing with their employers.

    The Right Kind of Therapy

    The right kind of psychotherapy is also important. Individuals with schizophrenia need to learn how to cope with the realities of their illness. In this regard, family members can be a tremendous help. Dr. M.I. Herz and colleagues at the University of Rochester conducted an 18-month study in 1995 of 82 schizophrenic outpatients at high risk for relapse. Forty-one patients were randomly assigned to "standard treatment" and 41 to "early-intervention treatment" (EIT). The latter consisted of weekly group or individual sessions, in which coping skills were emphasized, as well as reporting any changes in symptoms over the preceding week. Patients and family members were also taught about schizophrenia and how to recognize very early signs of a psychotic relapse.

    When such signs were reported, more frequent office visits and/or adjustment of medications would occur. Results showed that patients in the standard treatment group were hospitalized for a total of 351 days, vs. only 73 days for those in EIT. Thus, family members who are educated about schizophrenia can make a big difference in the lives of their loved ones.

    Finally, family members can join and support mental-health advocacy groups like the National Alliance for the Mentally Ill (NAMI), which provides important services to both patients and their families.

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