Helping chronic psychiatric patients adjust to sociopolitical changes in Poland.

According to the stress-diathesis model, persons with serious mental disorders, such as schizophrenia, have cognitive and psychophysiological vulnerabilities that under conditions of stress, lead to psychotic symptoms and diminished interpersonal functioning (Nuechterlein and Dawson 1984; Zubin and Spring 1977). Pharmacological and psychosocial treatments provide buffers to disease vulnerabilities by compensating for neurotransmitter abnormalities, directly reducing the experience of stress, teaching a range of social and instrumental skills that help patients cope with life problems, and dispersing patients' stress through a well-functioning support network (Liberman et al. 1984). To conduct psychosocial treatments well, clinicians must have knowledge regarding the community stressors that impact upon the patient, the range of skills necessary to navigate the hurdles of everyday life (Goldfried and D'Zurilla 1969), and the interpersonal factors that facilitate formation and maintenance of support systems (Tolsdorf 1976). Clinicians can develop individual rehabilitation plans that reflect patients' strengths and weaknesses in each of these areas.