Lysaker Paul H, Glynn Shirley M, Wilkniss Sandra M, Silverstein Steven M
Roudebush VA Medical Center and the Indiana University School of Medicine, Indianapolis, Indiana.
Psychol Serv. 2010 May 1;7(2):75-91. doi: 10.1037/a0019115.
Recovery from schizophrenia has been conceptualized to involve not only symptom remission of symptoms and achievement of psychosocial milestones but also subjective changes in how persons appraise their lives and the extent to which they experience themselves as meaningful agents in the world. In this paper we review the potential of individual psychotherapy to address these more subjective aspects of recovery. Literature on the effectiveness of psychotherapy for persons with schizophrenia is discussed and two different paths by which psychotherapy might modify self-experience are described. First we detail how psychotherapy could be conceptualized and tailored to help persons with schizophrenia to construct richer and fuller narrative accounts of their lives including their strengths, challenges, losses and hopes. Second we explore how psychotherapy could target the capacity for metacognition or thinking about thinking, assisting persons with psychosis to become able to think about themselves and others in a generally more complex and flexible manner. The needs for future research are discussed along with a commentary on how current evidence- and skill-based treatments may contain key elements which could be considered psychotherapeutic.
精神分裂症的康复不仅被概念化为症状的缓解以及心理社会里程碑的达成，还包括个体对自身生活评价的主观变化，以及他们在多大程度上体验到自己是世界上有意义的行动者。在本文中，我们回顾了个体心理治疗在解决康复中这些更主观方面的潜力。讨论了关于精神分裂症患者心理治疗有效性的文献，并描述了心理治疗可能改变自我体验的两种不同途径。首先，我们详细阐述如何将心理治疗概念化并进行调整，以帮助精神分裂症患者构建更丰富、更完整的生活叙事，包括他们的优势、挑战、损失和希望。其次，我们探讨心理治疗如何针对元认知能力或对思维的思考能力，帮助精神病患者以更复杂、更灵活的方式思考自己和他人。本文还讨论了未来研究的需求，并对当前基于证据和技能的治疗方法可能包含的可被视为心理治疗的关键要素进行了评论。
