The continuum approach – You, me and everyone else is included.

This article refers to schizophrenia, but we do not see people with this diagnosis as fundamentally different from anyone else. Rather, we have taken the continuum approach, which a is common approach in clinical psychology. This approach is based on the idea that we all have some tendency towards schizophrenia (or indeed any other mental health problem). The strength of this tendency will depend on a number of factors and will vary from person to person. These factors include basic personality, experiences people have had, how they deal with these experiences and how other people react to them.  We are influenced by many things in our lives as we develop and that makes a lot of difference.  Our personality does not dictate everything about how we behave. Rather, it acts as a filter through which life experiences pass. Many people with a diagnosis of schizophrenia will have had difficult experiences in the past; these may include relationship problems or frightening or negative events that have happened.  Many people with schizophrenia have had a range of traumatic experiences. This is also true of many people with other mental health problems and also of some people with no mental health diagnosis. The particular ways in which people react to and deal with their experiences are therefore probably associated with how they cope and the impact it has on mental health.  Individual beliefs, coping skills and approaches are of course only part of the story. None of us function in isolation and the reactions of other people to our behavior can be very important. If people have close and supportive relationships with key figures in their lives, they tend to have better outcomes than people who do not.

This is the most important aspect of treatment.

Most of us move up and down this continuum at different points in our lives, depending on all of the above factors, which can change over time. If someone has a tendency towards developing schizophrenia this does not mean that they will certainly do so. In fact, if life goes relatively smoothly this may be no more than an element of their personality. However, in the presence of repeated adversity the individual can move up this continuum and potentially reach a point at which schizophrenia is diagnosed. Even then, it remains perfectly possible to move back down the continuum, particularly if he/she receives the right balance of medical, psychological and social help for their specific circumstances.  This is the most important aspect of the treatment.  Remember this.

Many people with a diagnosis of schizophrenia and their families can live less disrupted lives if they can maintain contact with mental health professionals and services.  We also believe that there is a responsibility on both sides to negotiate this contact so that, it is mutually respectful.

Don’t take a passive role – you are not doomed.

There is now substantial scientific support that many healthy individuals appear to behave in a similar manner to people with a clinical diagnosis of schizophrenia, on a whole range of tests of thinking, attitudes and beliefs. This overlap supports our view that people with this diagnosis are clearly able to benefit from approaches that help them to address their problems in living. Like other people with emotional problems, schizophrenics can learn to feel happier, more secure, less frightened, more positive and more in control and do better generally. The ways in which people can achieve this can be through formal and informal support, counseling and changing life circumstances. There are things that you can do; receipt of this diagnosis does not mean that the individual needs to take a passive role in his or her future care.

Where there is a will, there is a way!

Therefore, when someone is an active agent in planning their own recovery, outcomes are likely to be better. One reason for this is that people who feel involved in the care decisions tend to actively engage with the program of care. Where such programs are either imposed, or passively accepted by an individual, there is a normal tendency to resist the suggestions or treatment offered. Such findings are not unique to the mental health field. Studies in social psychology and management science also indicate a human response to resist imposed change and to engage more with changes that the individual has an investment in. The purpose of this section is to  emphasize the importance of people having an active involvement in their own care.

One size does not fit all.

The things that help one person with schizophrenia do not necessarily help someone else. This can be true of medications and psychological help.

Doctor do fall short of expectations!

At times there is a conflicts between individual feeling frustrated and unheard by a service provider.  At times mental health service providers see the same people as difficult and uncooperative. However, most professionals just want to help people get on with their lives. Professionals, through their own training are becoming more aware of the importance of negotiating with and listening to clients' views. However, both clients and mental health professionals will at times disagree, and dealing with such disagreements with mutual 'respect can be key to developing positive therapeutic alliances. Doctors do fall short of expectations, as the treatment is still far from being ideal; but at least, they should not do any harm.


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