Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-25T06:34:44.414Z Has data issue: false hasContentIssue false
  • English
  • Français

Need-Adapted Treatment of Schizophrenia: Family Interventions

Published online by Cambridge University Press:  06 August 2018

Klaus Lehtinen
Klaus Lehtinen*
Affiliation:
Department of Clinical Medicine, University of Tampere, Box 607, SF-33101 Tampere, Finland
Get access Rights & Permissions [Opens in a new window]

Abstract

Need-adapted treatment of schizophrenia is an integrative treatment model developed in the Turku Schizophrenia Project. It is based on the interactional viewpoint and understanding on the interactional level. Experience of family and network therapy has shown that immediate interactions-oriented intervention is an essential starting-point for the treatment. It creates the possibility for the treatment as a whole to become a therapeutic process. For clinical purposes, it has seemed logical to divide the patients into three groups; the methods and focus of the family-oriented work differ somewhat between the groups. The main separator between these is the level of social functioning before the psychosis.

Type
II. The Treatment of Schizophrenia
Information
The British Journal of Psychiatry , Volume 164 , Issue S23: Integrated Approach to Schizophrenia , April 1994 , pp. 89 - 96
Copyright
Copyright © 1994 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alanen, Y. O. (1958) The mothers of schizophrenic patients. Acta Psychiatrica & Neurologica Scandinavica, 33 (suppl. 124).Google Scholar
Alanen, Y. O. (1975) The psychotherapeutic care of schizophrenic patients in a community psychiatric setting. In Studies of Schizophrenia (ed. Lader, M. H.) (special publication 10). London: British Journal of Psychiatry.Google ScholarPubMed
Alanen, Y. O., Räkköläinen, V., Laakso, J., et al (1980) Problems inherent in the study of psychotherapy of psychoses: conclusions from a community psychiatric action research study. In Psychotherapy of Schizophrenia (eds Strauss, J. S., Bowers, M., Downay, T. W., et al). New York: Plenum Press.Google Scholar
Alanen, Y. O., Räkköläinen, V., Laakso, J., et al (1986) Towards Need-Specific Treatment of Schizophrenic Psychoses. Berlin: Springer Verlag.CrossRefGoogle ScholarPubMed
Alanen, Y. O., Lehtinen, K. Räkköläinen, V. (1989) Utvecklandet av vården av nya schizofrenipatienter i Finland. Nordisk Psykiatrisk Tidsskrift, 43, 39–48.CrossRefGoogle Scholar
Alanen, Y. O., Anttinen, E. E., Kokkola, A., et al (1990) Treatment and rehabilitation of schizophrenic psychoses: the Finnish treatment model. Nordic Journal of Psychiatry, 44 (suppl. 22).Google Scholar
Alanen, Y. O., Lehtinen, K., Räkköläinen, V., et al (1991) Need-adapted treatment of new schizophrenic patients: experiences and results of the Turku Project. Acta Psychiatrica Scandinavica, 83, 363–372.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1980) Diagnostic and Statistical Manual of Mental Disorders (3rd edn). Washington DC: American Psychiatric Association.Google Scholar
Anderson, C. M., Reiss, D. J. & Hogarty, G. E. (1986) Schizophrenia and the Family. New York: Guilford Press.Google Scholar
Andolfi, M. & De Nichilo, A. (1989) The Myth of Atlas – Families and the Therapeutic Story. New York: Brunner/Mazel.Google Scholar
Bateson, G., Jackson, D. D., Haley, J., et al (1956) Towards a theory of schizophrenia. Behavioral Science, 1, 251–264.CrossRefGoogle Scholar
Brown, G. W., Monck, E. M., Carstairs, G. M., et al (1962) Influence of family life events on the course of schizophrenic illness. British Journal of Preventive and Social Medicine, 16, 55–68.Google Scholar
Brown, G. W., Birley, J. L. T. & Wing, J. K. (1972) Influence of family life on the course of schizophrenic disorder: a replication. British Journal of Psychiatry, 121, 241–258.CrossRefGoogle ScholarPubMed
Cecchin, G. (1987) Hypothesizing, circularity, and neutrality revisited: an invitation to curiosity. Family Process, 26, 405–414.CrossRefGoogle ScholarPubMed
Cullberg, J. (1992) Combining psychodynamics and biology. (In symposium; Verklighet och Visioner, arranged by Intresse Föreningen för Skitsofreni, 9–10 March, Stockholm.)Google Scholar
Doane, J. A., Falloon, I. R., Goldstein, M. J., et al (1985) Parental affective style and the treatment of schizophrenia: predicting course of illness and social functioning. Archives of General Psychiatry, 42, 34–42.CrossRefGoogle ScholarPubMed
Falloon, I. R. H. (1992) Early intervention for first episodes of schizophrenia: a preliminary exploration. Psychiatry, 55, 4–15.CrossRefGoogle ScholarPubMed
Fromm-Reichmann, F. (1948) Notes on the development of treatment of schizophrenics by psychoanalytic psychotherapy. Psychiatry, 11, 263–274.CrossRefGoogle ScholarPubMed
Gelcer, E., McCabe, A. E. & Smith-Resnick, C. (1990) Milan Family Therapy: Variant and Invariant Methods. London: Jason Aronson.Google Scholar
Gilbert, S. & Ugelstad, E. (1994) Patients’ own contributions to long-term supportive psychotherapy in schizophrenic disorders. British Journal of Psychiatry, 164 (suppl. 23), 84–88.CrossRefGoogle Scholar
Haley, J. (1984) Ordeal Therapy. New York: Jossey-Bass.Google Scholar
Hoffman, L. (1981) Foundations of Family Therapy. New York: Basic Books.Google Scholar
Kuusi, K. (1986) Prognosis of Schizophrenic Psychoses in Helsinki in 1975–1983 (monographs of Psychiatria Fennica, 13). Helsinki: Foundation for Psychiatric Research in Finland. (In Finnish, English summary.)Google Scholar
Leff, J. & Vaughn, C. (1985) Expressed Emotion in Families: its Significance for Mental Illness. New York: Guilford.Google Scholar
Leff, J., Kuipers, L., Berkowitz, R., et al (1985) A controlled trial of social intervention in the families of schizophrenic patients: two year follow-up. British Journal of Psychiatry, 146, 594–600.CrossRefGoogle ScholarPubMed
Leff, J., Berkowitz, R., Shavit, N., et al (1989) A trial of family therapy v. a relatives group for schizophrenia. British Journal of Psychiatry, 154, 58–66.CrossRefGoogle Scholar
Lehtinen, K. (1993) Need-adapted treatment of schizophrenia: a five year follow-up study from the Turku project. Acta Psychiatrica Scandinavica, 87, 96–101.CrossRefGoogle ScholarPubMed
Lehtinen, K. & Räkköläinen, V. (1986) Akuutin psykoosin systeemianalyyttinen hoita. Reports of Psychiatria Fennica, 71, 79–92 (in Finnish).Google Scholar
Lehtinen, K. & Räkköläinen, V. (1993) Community psychiatry as a psychotherapeutic device. In The Psychotherapy of Schizophrenia (eds Benedetti, G. & Furlan, P. M.). Göttingen: Hogrefe & Huber.Google ScholarPubMed
Lidz, T., Cornelison, A. R., Fleck, S., et al (1957) The intrafamilial environment of schizophrenic patients: II. Marital schism and marital skew. American Journal of Psychiatry, 114, 241–248.CrossRefGoogle ScholarPubMed
Maturana, H. R. & Varela, F. J. (1980) Autopoiesis and Cognition. Boston: Reidel Press.CrossRefGoogle Scholar
Maturana, H. R. & Varela, F. J. (1987) The Tree of Knowlege: the Biological Roots of Human Understanding. Boston: New Science Library.Google Scholar
Minuchin, S. (1974) Families and Family Therapy. London: Tavistock.CrossRefGoogle Scholar
Ojanen, M. & Sariola, E. (1986) Skitsofrenia: laitoskierteestä vapauteen. Helsinki: Otava.Google Scholar
Pao, P. N. (1979) Schizophrenic Disorders: Theory and Treatment from a Psychodynamic Point of View. New York: International Universities Press.Google Scholar
Räkköläinen, V. (1977) Onset of Psychosis: a Clinical Study of 68 Cases (Annales Universitatis Turkuensis, Ser. D, 35). Turku: University of Turku.Google Scholar
Räkköläinen, V., Lehtinen, K. & Alanen, Y. (1991) Need-adapted treatment of schizophrenic process: the essential role of family-centered therapy meetings. Contemporary Family Therapy, 16, 573–582.CrossRefGoogle Scholar
Rosenhahn, D. L. (1984) On being sane in insane places. In The Invented Reality: How Do We Know What We Believe We Know? (Contributions to Constructivism) (ed. Watzlawick, P.). New York: W. W. Norton. (Modified from the original published in Science (1973), 179, 250–258.)Google Scholar
Salokangas, R. K. R. (1986) Psychosocial outcome in schizophrenia and psychotherapeutic orientation. Acta Psychiatrica Scandinavica, 74, 497–506.CrossRefGoogle ScholarPubMed
Selvini-Palazzoli, M., Boscolo, L., Cecchin, G., et al (1978) Paradox and Counterparadox. New York: Jason Aronson.Google Scholar
Selvini-Palazzoli, M., Boscolo, L., Cecchin, G., et al (1980) Hypothesizing–circularity–neutrality: three guidelines for the conductor of the session. Family Process, 19, 3–12.CrossRefGoogle Scholar
Simon, F. B., Stierlin, H. & Wynne, L. C. (1985) The Language of Family Therapy: a Systemic Vocabulary and Sourcebook. New York: Family Process Press.Google Scholar
Singer, M. T. & Wynne, L. C. (1963) Differentiation characteristics of parents of childhood schizophrenics, childhood neurotics and young adult schizophrenics. American Journal of Psychiatry, 120, 234–243.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Endicott, J. & Robins, E. (1975) Research Diagnostic Criteria. New York: New York State Psychiatric Institute, Biometrics Research Division.Google ScholarPubMed
Strauss, J. & Carpenter, W. (1974) The prediction of outcome in schizophrenia. II. Relationships between predictor and outcome variables. Archives of General Psychiatry, 31, 37–42.CrossRefGoogle ScholarPubMed
Strauss, J. & Carpenter, W. (1977) Prediction of outcome in schizophrenia: five-year outcome and its predictors. Archives of General Psychiatry, 34, 159–163.CrossRefGoogle ScholarPubMed
Tarrier, N. (1991) Some aspects of family interventions in schizophrenia I–II. British Journal of Psychiatry, 159, 475–484.CrossRefGoogle Scholar
Tienari, P., Sorri, A., Lahti, I., et al (1985) The Finnish adoptive family study of schizophrenia. Yale Journal of Biology and Medicine, 58, 227–237.Google ScholarPubMed
Torrey, E. F. (1980) Schizophrenia and Civilization. New York: Jason Aronson. Warner, R. (1983) Recovery from schizophrenia in the Third World. Psychiatry, 46, 197–212.Google Scholar
Watzlawick, P. (1978) The Language of Change. New York: Basic Books.Google Scholar
Watzlawick, P. (ed.) (1984) Invented Reality: How Do We Know What We Believe We Know? (Contributions to Constructivism). New York: W. W. Norton.Google Scholar
Watzlawick, P., Weakland, J. H. & Fish, R. (1974) Change: Principles of Problem Formation and Problem Resolution. New York: Norton.Google Scholar
Waxler, N. E. (1979) Is outcome of schizophrenia better in non-industrial societies? Journal of Nervous and Mental Disease, 167, 144–162.CrossRefGoogle Scholar
Weakland, J. H. (1960) The ‘double-bind’ hypothesis of schizophrenia and three-party interaction. In The Etiology of Schizophrenia (ed. Jackson, D. D.). New York: Basic Books.Google Scholar
World Health Organization (1973) The International Pilot Study of Schizophrenia. Geneva: WHO.Google Scholar
World Health Organization (1979) Schizophrenia – an International Follow-up Study . Chichester: John Wiley.Google Scholar
Wynne, L., Ryckoff, I. M., Day, J., et al (1958) Pseudomutuality in the family relations of schizophrenics. Psychiatry, 21, 205–222.CrossRefGoogle ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.