Personal-therapy: a disorder-relevant psychotherapy for schizophrenia

While the long-term care of am-bulatory schizophrenia patients requires highly effective interper-sonal treatment skills among cli-nicians, there is little evidence to support an empirically validated individual psychotherapy of schizophrenia. Personal therapy (PT) attempts to address the ap-parent limitations of traditional psychotherapy by modifying the "model of the person " to accom-modate an underlying pathophys-iology, minimizing potential ia-trogenic effects of maintenance antipsychotic medication, control-ling sources of environmental provocation, and extending ther-apy to a time when crisis man-agement has lessened and stabil-ization is better ensured. By means of graduated, internal cop-ing strategies, PT attempts to provide a growing awareness of personal vulnerability, including the "internal cues " of affect dys-regulation. The goals are to in-crease foresight through the accu-rate appraisal of emotional states, their appropriate expression, and assessment of the reciprocal re-sponse of others. The strategies are supplemented by phase-speci-fic psychoeducation and behavior therapy techniques. Practical is-sues in the application of this new intervention are discussed. Preliminary observations from two samples of patients, one liv-ing with and the other living in-dependent of family, suggest dif-ferential improvement over time among PT recipients