How Long-Term Residential Schizophrenia Treatment Promotes Independent Living

While we now have better models for providing transformative schizophrenia treatment experiences than ever before, implementing those models in effective ways can be difficult. Outpatient treatment can result in slow progress and allows for only relatively brief periods of doctor/client contact, which means it is often difficult to truly focus on the full spectrum of needs. Short-term residential treatment programs offer a higher intensity of treatment and allow for the implementation of a more comprehensive treatment plan, but the limited duration of such programs often means that clinicians must still focus primarily on stabilization rather than true long-term recovery. For people who have serious functional impairment, these programs simply can’t address your child’s broad range of needs in a way that results in meaningful change.

Long-term schizophrenia residential treatment programs, on the other hand, are able to offer both the intensity and duration of care necessary to go beyond immediate stabilization. In these environments, your loved one can receive treatment for acute, positive symptoms while engaging in therapies and practices targeted toward negative symptoms as well as bolstering independent living skills. The benefits of long-term residential treatment programs include:

Enhancing Pharmacotherapy Planning and Adherence

Pharmacotherapy is the cornerstone of schizophrenia treatment, but each person’s symptomatology and response to particular medications can vary drastically. Long-term residential treatment programs are able to offer in-depth clinical assessments as well as ongoing observation to determine the precise nature of each person’s challenges. With this information, clinicians can design personalized medication plans that target your loved one’s symptoms and closely monitor both efficacy and side-effects. This greatly increases the chances of rapidly finding medications that work well and are well-tolerated.

Unfortunately, many people living with schizophrenia struggle with medication adherence, even when medications are working well. In a long-term residential treatment program, your loved one will be given the support they need to take their medication as prescribed and address any concerns they have about their treatment. As their condition improves and they gain more independence, they can take on greater responsibility for their own adherence until it becomes a natural part of their lives. Simultaneously, they can learn important skills to help counter side-effects and improve tolerability, such as exercise and diet to minimize weight gain, making it more likely that they will stick to treatment. Not only is medication adherence itself an important skill, it also addresses positive symptoms that interfere with functionality.

Improving Emotional, Behavioral, and Social Functioning

While medication is invaluable in the treatment of schizophrenia, it often does not fully resolve positive symptoms, does not typically resolve negative symptoms, and does not automatically imbue your loved one with the skills necessary to regulate emotions and behaviors. As Drs. David Kingdon and Douglas Turkington point out, “Pharmacological therapy can leave as many as 60% of psychotic patients with persistent positive and negative symptoms.” Individual psychotherapy and group therapies, however, can address these challenges.

In particular, cognitive behavioral therapy (CBT) has been found to be greatly effective in addressing both positive and negative symptoms as well as providing the insight and skills necessary for emotional and behavioral regulation. This includes learning strategies for:

• Reality testing
• Organizing confusing experience
• Decatastrophizing psychotic experience
• Reframing disturbing thoughts
• Replacing destructive coping mechanisms with healthy alternatives

Just as importantly, CBT can be used to help draw your loved one out of isolation and improve self-awareness, focus, and social understanding. As explained in the Harvard Mental Health Letter, “They are taught how to safely communicate their own needs and show that they understand the needs of others.” Combined with a variety of other therapeutic modalities, your family member can engage in a comprehensive process of growth and transformation.

The duration of residential schizophrenia treatment programs affords your son or daughter the ability to gradually integrate their new skills in a safe and supportive environment; after all, it takes time for new learning to take root and replace damaging or irrational emotions, thoughts, and beliefs. Additionally, the social milieu of these programs means that your loved one has continuous opportunities to practice new skills throughout each day as they interact with clinicians and peers, strengthening their learning and enhancing self-sufficiency.

Practicing Independent Living

One of the features that distinguish long-term residential treatment programs from other forms of treatment is the opportunity it affords to gradually transition to independent living. These programs are structured to provide the support your loved one needs at each stage of the healing process. In the beginning of their stay they will likely need a 24-hour supported living environment, but as their symptoms diminish and their skills improve, they can move on to semi-independent living that allows for greater degrees of independence, a stronger focus on self-care and self-management, and vocational/educational support. Once their skills are strong enough, your loved one can step down into an independent living program and, eventually, live on their own while participating in outpatient program services as needed.

This structure ensures that each person receives the level of support they need at each phase of healing while allowing them hone and fortify their independent living skills. Throughout the program, your loved one will be monitored to a degree appropriate for their stage of recovery to ensure that they have the resources necessary to stay safe, healthy, and further develop their independence. While this process should never be rushed, it is also vital to provide chances for your loved one to get out of their comfort zone, try new things, and realize that their potential is greater than they imagined.

Although your loved one is the person in treatment, recovery is a project for the whole family. That’s why your involvement in the treatment process is essential. By participating in specialized family programming as well as ongoing family therapy, you can gain the insight, support, and skills you need to cope with your loved one’s illness and your changing role in their life.

Even if you want nothing more than to see your adult child build a happy, healthy, and independent life, achieving that goal can bring complex feelings to the surface. It may be challenging for you to recognize and trust in their new abilities and your instinct may be to stay in a caretaking role. Even if you want to break out of the caretaking dynamic, it can be hard to reorient your relationship along more appropriate lines or to imagine an identity for yourself outside of caretaking. Your dynamics with other family members may also change as your son or daughter gains independence. The treatment program you choose should provide you with the guidance and support to navigate these difficult feelings and help you create healthier, more loving relationships with your family members.

Of course, completing treatment doesn’t mean that your child no longer needs your support. Schizophrenia is a chronic condition and one that must be monitored throughout their lives. While treatment can greatly expand your son or daughter’s abilities and give them the opportunity to live up to the potential, they may still face emotional, behavioral, and functional challenges. It is imperative to create a plan for how to provide the support they need moving forward while taking into account the progress they have made in treatment.

By working with a long-term residential treatment program, you can give your adult child, yourself, and your other families members the chance to heal, grow, learn, and thrive. Together, you can become closer, stronger, and more resilient and open up the door to a bright new future.