Theory-based intervention: a case study using Sullivan's interpersonal theory of psychiatry.

The essence of the schizophrenic dynamism is a confusion in the interpersonal relations by the appearance in awareness of referential processes ordinarily excluded from awareness (Sullivan, 1956; 361). Its etiology can be traced to a pathological symbiotic relationship with the mothering one in which there is an overwhelming degree of anxiety transmitted to the infant. A consistent, frequent, nonthreatening and non-demanding approach is the basis for all nursing interventions. The emphasis of treatment is on identifying and strengthening the patient's assets and raising self-esteem. Interventions are directed toward the patient's resocialization and reality-testing. Staff effort is required to create a milieu in which it is desirable and possible for patients to learn autonomy. Patients should be encouraged to look at their feelings in the light of their past experiences, but with a recognition that the past is over and beyond their control. What happens in the future depends on their efforts now. Finally, nurse-therapists need to be secure, thoughtful, and empathic in treating schizophrenic patients. The challenge for staff is to be absolutely consistent and communicate acceptance and positive regard whatever the patients' behavior.