Hogarty G E, Kornblith S J, Greenwald D, DiBarry A L, Cooley S, Flesher S, Reiss D, Carter M, Ulrich R
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, PA 15213, USA.
Schizophr Bull. 1995;21(3):379-93. doi: 10.1093/schbul/21.3.379.
While the long-term care of ambulatory schizophrenia patients requires highly effective interpersonal treatment skills among clinicians, there is little evidence to support an empirically validated individual psychotherapy of schizophrenia. Personal therapy (PT) attempts to address the apparent limitations of traditional psychotherapy by modifying the "model of the person" to accommodate an underlying pathophysiology, minimizing potential iatrogenic effects of maintenance antipsychotic medication, controlling sources of environmental provocation, and extending therapy to a time when crisis management has lessened and stabilization is better ensured. By means of graduated, internal coping strategies, PT attempts to provide a growing awareness of personal vulnerability, including the "internal cues" of affect dysregulation. The goals are to increase foresight through the accurate appraisal of emotional states, their appropriate expression, and assessment of the reciprocal response of others. The strategies are supplemented by phase-specific psychoeducation and behavior therapy techniques. Practical issues in the application of this new intervention are discussed. Preliminary observations from two samples of patients, one living with and the other living independent of family, suggest differential improvement over time among PT recipients.
虽然对非住院精神分裂症患者的长期护理需要临床医生具备高效的人际治疗技能，但几乎没有证据支持一种经过实证验证的精神分裂症个体心理治疗方法。个人治疗（PT）试图通过修改“人的模型”以适应潜在的病理生理学，尽量减少维持性抗精神病药物的潜在医源性影响，控制环境刺激源，并将治疗扩展到危机管理减轻且稳定得到更好保障的时期，来解决传统心理治疗的明显局限性。通过逐步的内部应对策略，PT试图让患者越来越意识到个人的易感性，包括情感失调的“内部线索”。目标是通过对情绪状态的准确评估、适当表达以及对他人相互反应的评估来提高前瞻性。这些策略辅以特定阶段的心理教育和行为治疗技术。讨论了这种新干预措施应用中的实际问题。来自两个患者样本的初步观察结果，一个与家人同住，另一个独立于家人生活，表明随着时间的推移，接受PT治疗的患者有不同程度的改善。
