For the past 50 years, the predominant model in health treatment has focused on medication as the most important aspect of treatment for schizophrenia, but Murray State Assistant Professor of Psychology Dr. Michael Bordieri says a couple of weeks ago a new study finds the combination of talk therapy with medication to be an effective treatment. On Sounds Good, Tracy Ross speaks with Dr. Bordieri about the study and the history of treating schizophrenia.
The rise of medication as treatment came in the 1950s with the development of antipsychotic drugs, an important aspect of treating schizophrenia often referred to as the "thorazine revolution." Before then, there was very little help for people who were suffering besides "warehousing" them, Dr. Bordieri says. Medication offered a better life for those diagnosed with schizophrenia.
A new study suggests that therapy can also play an important role in treatment. This study comes from the National Institute for Mental Health Initiative, looking at how one can treat an initial episode. The navigate system combines consumer focus medication management with family education, individual talk therapy based on a resiliency model (bolstering strengths) and supportive employment and education aimed at helping individuals engage in the community. The study finds a significantly higher quality of life than those who only received medication.
Medication can help, but it can't help someone find a purpose, there is no "purpose pill," Dr. Bordieri says. In the interventions, talk therapy, family support and supportive employment make a huge difference in someone's life - less likely to relapse or end up in the hospital. It's a positive for the individual by reducing their suffering and living a more meaningful life and also for society, seeing a lower disease burden, spending less money keeping people in hospitals and instead investing the money into programs that help people get out and lead a meaningful life.
The problem has been a question of who is going to pay for these treatments. After the release of this study, the centers for Medicare and Medicaid have released new guidelines that support the use of these techniques, leading to an increase in these treatments. Dr. Bordieri says people in the combined approach are actually taking less medication.
This may be a jumping off point for emerging evidence across psychological difficulties like anxiety and depression. There's role for therapy, he says, and perhaps therapy might be more effective than medication alone. With trials like this, providing high quality psychotherapy can be made more accessible at the community level.
