Personal therapy has pervasive effects on the social adjustment of patients with schizophrenia that are independent of relapse prevention. Supportive therapy, with or without family intervention, produces adjustment effects that peak at 12 months after discharge and plateau thereafter. However, personal therapy, a definitive psychosocial intervention, continues to improve the social adjustment of patients in the second and third years after discharge. Brief treatment would appear to be less effective than a long-term, disorder-relevant intervention for schizophrenia.

Personal therapy had a positive effect on adverse outcomes among patients who lived with family. However, personal therapy increased the rate of psychotic relapse for patients living independent of family. The application of personal therapy might best be delayed until patients have achieved symptom and residential stability.

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.

No abstract

Five conditions were compared in a study attempting to disassemble a behavioral self-control program previously shown to be effective in the treatment of moderate depression. Conditions were: (1) Self-Monitoring only; (2) Self-Monitoring plus Self-Evaluation; (3) Self-Monitoring plus Self-Reinforcement; (4) the full Self-Control package including Self-Monitoring, Self-Evaluation, and Self-Reinforcement; and (5) a Waiting List Control. Fifty-six volunteer female subjects from the community were screened on MMPI and Research Diagnostic Criteria for moderate, nonpsychotic, nonbipolar depression. Therapy was conducted in seven highly structured weekly 11/2 hour group sessions. Results indicated that all treatment conditions did better than the Waiting List controls on self-report and interviewer rating measures of depression. Only minor differences were found on behavioral observation measures taken in interview and group settings. No consistent effects were found for separate components, with the possible exception of a negative effect for the Self-Evaluation component on some measures. Results are discussed in terms of research strategies for assessing therapy programs.