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Keks et al,
Box 2

 

 

 

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© 1998 MJA

Treating the whole problem: targets and interventions for patients with chronic psychiatric illness

People with disorders such as chronic schizophrenia require interventions to improve their social functioning as well as to control symptoms

Target for intervention Intervention

Psychosis (delusions, hallucinations, disordered thinking) Antipsychosis medication; counselling -- reality reinforcement, support
Social and emotional deficits (flat affect, poverty of thinking, social withdrawal, lack of motivation) Counselling, encouragement to join activity groups/programs, case management to access rehabilitation activities
Cognitive deficits (poor concentration, memory problems, poor problem-solving and executive function) Counselling -- assistance with planning for goals, memory prompts, assistance in task performance by allied health/nursing professionals
Mood disorder (depression, mania, anxiety) Medication, counselling, cognitive psychotherapy
Functional deficits (in intimate relationships, social network, occupation, basic living skills) Assistance to engage in occupational therapy, social skills training, training in activities of daily living, occupational rehabilitation (e.g., job support clubs)
Physical state (including alcohol/drug use) Assessment, treatment for specific physical disorders (e.g., heart disease and airway disease -- more common in alcoholics), nutritional and dental hygiene, encouragement to reduce alcohol/drug use
Effects on carers and community Support groups (service-initiated and self-help), education about illness, counselling -- assistance with problem-solving, psychotherapy (e.g., for the family)
Social handicaps (financial resources, housing, stigma) Financial assistance, housing, assistance with good attainment (e.g., finding and joining a social program)

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