Psychosocial rehabilitation in schizophrenia: Beginnings in acute hospitalization

Abstract

Schizophrenic patients discharged from acute inpatient settings are often unprepared to function outside the hospital, leading to recidivism and frequent rehospitalization. Social skills training programs addressing this need have hitherto only been developed for use in outpatient or long-term inpatient settings. We describe the development of a social skills training program for application in a short-term acute inpatient unit. Nursing coordinates the program, which is designed for a 3 to 4 week hospitalization and is delivered in an open group setting. The training program emphasizes communication skills, problem solving, affect identification, needs recognition, and social relatedness. The program uses group discussions, writing tasks, physical activity, education, role-play, feed-back, and assignments. Goals include assessment of individual deficits, inculcation of awareness that life-objectives can be identified and achieved, assistance with transition to postdischarge living situation or outpatient treatment program, and development of awareness of one's roles and responsibilities. The evolution and present structure of the program are described and four representative lessons are detailed.

Expectativa de desempenho social de pacientes psiquiátricos internados em hospital geral

“…Essa melhora poderia ser justificada pelo enfoque terapêutico da UP estudada, que não está voltada apenas para a remissão dos sintomas, mas também para a reintegração social. Assim, conforme proposto anteriormente, 12 a reabilitação social pode ser iniciada em uma unidade de internação aguda de curto prazo. No entanto, não se pode descartar que essa melhora no desempenho pode ter ocorrido devido à remissão dos sintomas, uma vez que estudos anteriores verificaram associação entre o ajustamento social e os sintomas psiquiátricos.…”

“…Na internação, foi solicitado aos pacientes e aos familiares que tomassem como referência a semana anterior à mesma. A aplicação dos formulários na semana que antecedeu a alta hospitalar minimiza a influência da sintomatologia do paciente sobre a sua auto-avaliação (12). Nas outras três medidas foram tomadas como referên-cia a semana anterior.…”

Die Rolle der Psychoedukation in der stationären Behandlung psychisch Kranker

“…In Pflegefachzeitschriften wurden einige Konzeptbeschreibungen veröffentlicht, jeweils ohne klinische Evaluation, mehrheitlich aus der Anfangszeit der Psychoedukation [29]. Vereinzelt wird über stationäre Psychoedukation in Einzelsitzungen berichtet [24].…”

Role Development Applied to Art Therapy Treatment of an Artist Diagnosed with Schizophrenia

“…One of the most severe types of mental illness is schizophrenia (American Psychiatric Association, 2000). Individuals diagnosed with schizophrenia often have deficits in learning and/or maintaining the task and interpersonal skills necessary to enact positive, socially acceptable roles (Anzai, Yoneda, & Kumagai, 2002;Liberman et al, 1993;Mann, Tandon, Butler, Boyd, Eisner, & Lewis, 1993;Torres, Mendez, & Merino, 2002).…”