Psychosocial Rehabilitation

Psychosocial Rehabilitation

The developmental consequences of schizophrenia are substan-tial with typical onset of the first psychotic episode in late ado-lescence or young adulthood. People with schizophrenia become progressively more removed from their peer group, fail to achieve (or sustain) adult milestones such as marriage, higher education and employment, and often become socially isolated. These functional, psychosocial consequences become more severe and entrenched as illness duration increases, and result in multiple treatment needs that are superimposed on the neurobiological as-pects of illness. While innovative new medications could poten-tially ameliorate (or compensate for) some of the consequences of anomalous neural development, it is unlikely that any pharma-cological approach could restore normal brain function. Further-more, no medication could undo the lifelong consequences of im-paired learning, failure to master adult developmental tasks, and social withdrawal. These impairments mandate a multifaceted approach to treatment that includes an array of psychosocial strat-egies, of which rehabilitation plays a key role (Bellack, 1989).

The term rehabilitation is generally used to imply a sub-category of psychosocial treatment in which there is an empha-sis on teaching/training, rather than discussion, and the focus is primarily on behaviors and functioning, rather than on intra-psychic processes (thinking and feeling). Reference is made to psychosocial intervention when the issues have generality to the broader domain of psychological treatment.