How Can Schizophrenia Be Treated More Ethically?

Over the years, my work with mental health patients has led me to develop certain ideas on how to ethically treat schizophrenia. I understand that these ideas might not be to the liking of all therapists, but they reflect a commitment to respect, empathy, and client-focused care. This approach is crucial in creating a therapeutic environment where patients feel heard and understood.

Respecting the Patient’s Reality

Mental health professionals must treat patients with respect, which means acknowledging and validating their experiences, even if we do not necessarily agree with them. For instance, if a patient believes that they are hearing voices, we do not dismiss or argue against their experience, but we can also address it not as clear hallucinations but as a symptom that may require further investigation. This approach allows us to build a trusting relationship and find effective treatment strategies.

Building Trust and Relationship

Building a strong therapeutic relationship is fundamental in treating schizophrenia. This involves minimizing the power differential between therapist and patient by being more casual and showing interest in their strengths while addressing their deficits. For example, a patient who once played the saxophone before developing symptoms could be encouraged to continue this activity as a way to build on their strengths and enhance their well-being.

Additionally, involving family members in the treatment process can be immensely beneficial. Families are often eager and willing to help, and respecting their perspectives can lead to a more comprehensive and supportive treatment environment. However, it's important to recognize that traditional views of toxic or abusive families are often outdated and may not reflect the reality of many families of people with schizophrenia.

Collaborative Goals and Decision-Making

Working collaboratively with the patient is another crucial aspect. Therapists should engage in joint goal-setting and support the patient in achieving these goals. This approach acknowledges that the patient’s future is not easily predictable, and therapy should be a partnership in which both parties actively participate. For example, if a patient expresses a desire to pursue higher education, the therapist should work with the patient to set and achieve these goals, whether they succeed or fail, and provide emotional support and guidance.

Respecting Individual Choices and Limitations

Therapists must avoid assuming that they know what is best for the patient in every aspect of their lives. Each patient’s journey is unique, and their decisions should be respected. When a therapist is young, they might be overconfident in their assessments of what a patient can or cannot do. However, as experience grows, it becomes clearer that patients have the potential to achieve more than initially anticipated. Whether a patient aims to go to college or another goal, the therapist's role should be to support and celebrate their achievements while also providing emotional support through setbacks.

Concluding Thoughts

By adopting a client-centered approach, therapists can better support patients with schizophrenia. This includes respecting their realities, building strong relationships, involving families, and collaborating on goals. Through these ethical practices, we can help patients navigate their journey with more dignity and hope.