Rehabilitation to Restore Social Function
Since antipsychotic medication was introduced in 1950s, the treatment and rehabilitation of schizophrenia has improved significantly. With the advancement of psychopharmacology and the emergence of new antipsychotic medications, in recent years the treatment outcome for psychosis has become increasingly hopeful. However, evidence shows that antipsychotics are only partially effective in eradicating the negative symptoms of schizophrenia, and they are shown to be ineffective for addressing associated cognitive disorders and social dysfunction. Because of psychiatric disability, some persons with schizophrenia are unable to live normally in society. Many studies have indicated that rehabilitation of social function can relieve negative symptoms of schizophrenia and improve both cognitive and social functioning. In addition, rehabilitative intervention for patients with schizophrenia can build self-confidence and promote a sense of social responsibility, thus, enabling these persons with schizophrenia to become more socially active and independent.
Rehabilitation to restore social function of hospitalized patients aims to relieve psychiatric symptoms and improve cognitive and social function by practical skills training. This training can enable psychiatric patients to achieve a higher quality of life and obtain comprehensive rehabilitation. At present, the following is included in our rehabilitative training program:
1. Training of independent living and social communication skills according to the rehabilitative program developed by R.P. Liberman, an American expert of psychiatric rehabilitation
2. Promotion of gradual readjustment to family and society by use of weekend passes that allow inpatients on the rehabilitation ward to spend limited time at home before actual hospital discharge
3. Training of cognitive function by structured activities that include reading, painting, dancing, drama, music, pottery handwork and other artistic forms
4. Training of various specific vocational skills
Combined Treatment of Traditional Chinese Medicine (TCM) and Western Medicine
The Department of Combined TCM and Western Medicine includes a clinic, an acupuncture therapy treatment room and a laboratory. The successful experience of combining TCM and Western medicine for the treatment of mental illness has led to greater use of this combined therapy in the care of our hospital’s patients.
We strive to integrate the essence of traditional Chinese medicine with new advancements of modern Western medicine and technology. By drawing upon the strengths of each of these two forms of medicine and overcoming their weaknesses, we believe we can provide high quality treatment for psychiatric patients.
With TCM we can presently treat various kinds of mental illnesses, including emotional disorders. We can also decrease side effects due to antipsychotic medicine use.
1. Differentiate symptoms, signs and illnesses by TCM.
We combine TCM with Western medicine to differentiate symptoms and illnesses so as to treat both primary and secondary symptoms.
2. Acupuncture therapy for mental disorders
Decades of clinical practice has shown that electro-acupuncture therapy is safe and effective for depression. Its curative effect is equal to that of antidepressant drugs but with fewer side effects. Moreover, acupuncture therapy also proves useful for treatment of other mental disorders.
3. The combination of Traditional Chinese Medicine and Western Medicine
The effectiveness of the treatment of schizophrenia with combined Traditional Chinese Medicine and low doses of antipsychotics has been demonstrated in many psychiatric hospitals. This combined therapy can reinforce the desired treatment effect, relieve drug side effects and enhance patient treatment compliance.
Psychotherapy
Brief Introduction to Morita’s Therapy
Morita therapy was founded by Mr. Morita Shoma of Japan. After having been diagnosed with neurosis he began to study the illness with the intent of not only helping himself, but also helping others who suffered from it. At the age of 40, Morita Shoma developed Morita’s therapy based on his experience in curing his own and others’ neuroses. In our hospital, Morita’s therapy has been enriched and adapted by absorbing ideas and methods from cognitive therapy, psychoanalysis and behavioral therapy. With ten years of research and clinical practice, a Chinese adaptation of Morita’s therapy has been formulated for use within the context of Chinese culture and society. As one of the most effective psychotherapeutic methods in China, it has proven to be a convenient, rapid and practical way to treat various kinds of neuroses and other mental disorders.
Indications for use of Morita’s Therapy:
1. Various kinds of neuroses, such as phobias, anxiety disorders, obsessive-compulsive disorders, neurasthenia, hypochondria and other somatoform disorders
2. Various kinds of psychogenic disorders, psycho-physiological disorders, and psychosexual disorders
3. Schizophrenia in remission, depression, dysthymia (depressive neurosis) and mental disorders due to organic disease
4. Certain kinds of personality disorders
Brief Introduction to Psychoanalysis
Psychoanalysis is a special psychotherapy developed by Sigmund Freud, an Austrian psychiatrist. This therapy requires long-term commitment and intervention. It emphasizes the internal mental world of the patient and pays close attention to desire and motivation in the sub-consciousness.
Psychoanalysis or psychodynamic psychotherapy supports the free expression of any idea, sensation, fancy, wish or feeling without value or moral judgment and provides logical processing when the patient engages in free association. By free expression, the motive and conflict in the patient’s sub-consciousness can be found and understood. The therapeutic relationship between patient and therapist can duplicate the relation between the patient and his important object in the past (such as parents, brothers and sisters), and also bring about the reappearance of the complicated or inconsistent passion and desire as well as intra-psychic conflict. Based on trust and cooperation, the reproduced material and the empathic relationship can be clarified and explained. This, in turn, can regulate and repair the emotional relationship with the important past object, adjust the psychological coping style, and eliminate the intra-psychic conflict. With this therapy the mental attachment to the symptom can be released and the symptom can be eliminated. The process of the therapy can promote the development of a more mature personality and improve the patient’s ability to love, to experience pleasure and to work.
Brief Introduction to Family Therapy
Family therapy was developed by clinicians in Western countries and is an offshoot of traditional psychotherapies in which the individual is the object of treatment. However, family therapy overcomes a major limitation of individual psychotherapy—focusing only upon the identified patient—by incorporating a systems approach. Introduced to China in the 1980’s, family therapy has rapidly shown a strong therapeutic effect because of the strong emphasis of family ties in Chinese culture. Regular therapy sessions include all or at least some of the family members in addition to the patient. By gaining an understanding of the problems involved and learning to make adaptive changes, the family can support the patient’s own learning and change process. Sometimes a dramatic change can occur even with only one session. Since it is relatively simple, convenient and effective, family therapy has been increasingly accepted by patients and their families in China.
Brief Introduction to Cognitive Behavior Therapy (CBT)
Based on the hypothesis that cognition can affect feeling and behavior, cognitive behavior therapy is the generic name of various selected psychotherapies which support the notion that negative cognitions can be changed by the application of cognitive and behavioral skills. Negative cognitions are distorted, unreasonable or negative beliefs and ideas that are viewed as leading to emotional disorders or maladjusted behaviors.
The main viewpoint of CBT is that the cognitions (or thoughts) primarily direct behavior and emotions. Thus, maladaptive behavior and negative emotions are seen as strongly related to distorted cognitions. The cognitive behavioral therapist helps patients to identify inappropriate cognitions and correct them or replace them with more appropriate ones. With cognitive skills training patients learn to examine their own thoughts, identify those that are distorted and then bring the latter closer to reality. This change to more positive cognitions, in turn, has a positive effect on emotions and behaviors and promotes improved social adaptations. Deeply favored by therapists and patients, this therapy is widely used in our hospital and plays an important role in adjusting emotion and changing behavior.
Brief Introduction to EEG Biofeedback Therapy
In the electro-encephalogram (EEG) biofeedback therapy, α wave and θ wave are used as feedback messages. Sound and light are used to indicate the occurrence of α wave. This therapy is applicable not only for the treatment of epileptic attacks and depression, but also to train athletes in relaxation and/or concentration. In addition, EEG biofeedback therapy of θ wave can be used to treat neuroasthenia and insomnia.
Brief Introduction to Hypnotherapy
Hypnotherapy is a kind of psychotherapy used to treat some kinds of mental disorders with induced trance. In brief, the hypnotist guides the patient into a trance-like, conscious, hypnotic state. In this state the patient’s suggestibility is significantly increased. The hypnotist then gives the patient suggestions for positive future changes involving sensations, cognitions and behaviors. With integration of the suggestive messages some mental symptoms and somatizations may be relieved or eliminated.
Brief Introduction to Group Therapy
Group therapy is an important form of psychotherapy that has been in use for nearly 100 years. It has several advantages over individual psychotherapy. Group therapy is applicable for treatment of a group of selected patients with similar mental symptoms. One or two trained therapists lead the group. By use of psychotherapeutic skills and the group process, group members learn to communicate more effectively with each other and the therapists. By this interaction negative feelings and maladaptive behaviors can be relieved and the development of personality promoted.
Exploratory Eye Movement Examination
Since mental health has increasingly gained focus and consideration, psychiatrists require methods for rapid screening and discrimination of mental disorders. In the past, diagnosis for mental illness depended largely on the subjective information of the patient’s history, as given by family members, and of the psychiatric interview performed by the physician. Our hospital has purchased an Exploratory Eye Movement System to discriminate schizophrenia from other mental disorders. In this examination the patient lies on a chair and watches a small screen in front of him or her. Then the patient is asked to follow some instructions and answer some questions. The system automatically analyzes the results and provides an auxiliary diagnosis. Lasting about 10 minutes, the examination is safe and convenient with diagnosis concordance rate of 70-80% when compared to clinical diagnosis.
Pupil Dilation Test
Alzheimer’s disease is a common form of senile dementia with slow onset. By the time a definitive diagnosis is made, the patient’s intelligence and memory has usually declined markedly. Our hospital has purchased the Pupil Dilation Test System to provide clues for an earlier diagnosis of Alzheimer’s disease. The examination is performed in a dark room with the patient lying on a chair. A technician puts an eye drop of a diluted mydriatic agent into one of the patient’s eyes. Then the patient is asked to watch a small screen in front of him or her. The system automatically records the changes of the patient’s pupils and draws a corresponding curve on a computer screen. Based on the ratio of two pupils’ diameters, the system can provide supporting information for the early diagnosis of Alzheimer’s disease. The entire test requires 40 minutes. Research has showed that diagnosis by Pupil Dilation Test has a high concordance with clinical diagnosis.