We currently have different types of psychological intervention for schizophrenia, and one of them is integrated psychological therapy.
Having traveled an irregular path, dominated by Kraepelin’s pessimistic and organist view of psychiatry and psychoanalysis, which regarded dementia as a narcissistic narcissist in which transfer and analytical treatment were impossible, today the picture is different.
- This meant a change in therapeutic care.
- If at first we focus solely on the treatment of schizophrenia or rehabilitation after deterioration.
- We now have therapies to treat the symptoms themselves.
As we said, one of them is the integrated psychological therapy for Roder and Brenner’s schizophrenia, the subject of this article.
Key advances in schizophrenia treatment strategies have been developed and refined based on the vulnerability-stress model, a framework that shows how the interaction of environmental stressors with biological vulnerability works.
Based on the assumption that schizophrenics have deficiencies at different functional levels of motor organization – attention-perceptual, cognitive, microsocial and macrosocial – that level deficiencies can harm others and that different levels have a hierarchical relationship between them, Brenner and his collaborators have developed the penetration model.
This model served as the basis for explaining schizophrenic symptoms and developing integrated psychological therapy (TIP), establishing that cognitive enhancements will have an impact on behavioral improvements.
This is a treatment that is performed in a group of 5 to 7 patients, and was developed specifically for this part of the population. The goal of therapy is to improve the cognitive and social abilities of schizophrenic patients.
Therapy is done in sessions of 30 to 60 minutes, three times a week for three months.
The type of patient considered fit for treatment is those 18 to 40 years old, who do not normally use drugs (sporadic use), who live with the family, who have not spent much time in the hospital and who have a mild or moderate executive deficit. before.
It is a treatment applied to more than 700 patients in various sociocultural contexts, so we can confirm that this is one of the most psychologically effective programs to treat schizophrenic symptoms.
Integrated psychological therapy for schizophrenia includes five subprogrammes designed to improve cognitive dysfunction and social and behavioral deficits characteristic of the disease.
These are hierarchical subprogrammes, so early interventions focus on basic cognitive skills, intermediaries transform cognitive skills into verbal and social responses, and these empower patients to solve more complex interpersonal problems.
Each subprogramme has been designed so that as therapy progresses, the patient’s needs gradually increase. Progress ranges from simple, predictable tasks to more difficult and complex tasks.
At the same time, the structuring of therapy decreases, that is, it goes from a very structured beginning to a much more spontaneous ending.
In addition, each subprogram begins with an emotionally flat material, then gradually increases its emotional load.
The various integrated psychological therapy subprogrammes for schizophrenia are summarized below:
The initial cognitive differentiation subprogramme improves patients’ elementary cognitive processes, such as attention or abstraction, although performance remains below normal.
The data available to date cannot confirm the penetration hypothesis on which integrated psychological therapy of schizophrenia is based. Effects on cognitive variables do not translate into consistent behavioral improvements.
The ability to process information correctly becomes a necessary condition, but is not sufficient for normal driving.
Modulation factors, such as self-image, can inhibit the penetration pattern, however, other studies conducted by the authors have found opposite results.
In other words, from social rehabilitation, it is possible to have a more appreciable downward effect on basic cognitive functions, activating coping skills, developing intact cognitive processes and improving the concept of itself.
Currently, based on integrated psychotherapy, new programs have emerged, such as emotional management training, aimed at reducing the influence of dysfunctional emotional states on cognitive and social functioning.
A professional and leisure skills training program has also been developed to facilitate the generalization of skills acquired in therapy.
Finally, we have a coping-oriented treatment, based on psychoeducational programs with the aim of correcting the ways of coping with the schizophrenic patient.