Best use of therapy for first time schizophrenic?

Finally almost 2 months later after first identification/hospitalization in therapy with a 1:1.

What’s the best way to make use of this? Discuss my current fears of this disease? Discuss other current issues like fear of loss of my caregivers?
Look to the past childhood where I think some of this might have come from?

If you’ve been in 1:1 therapy, what has worked best for you?

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From my personal perspective, schizophrenia is an actual disorder of the brain. I think of it as the brain has suffered an injury - like from a lightning strike. Some areas of the brain are damaged and now have limited functioning. Other areas have hot spot moments that flare up and cause psychosis. Sometimes those same hot spot moments even allow the areas of limited functioning to work again.

Therapy that is most successful for people living with schizophrenia is CBT Cognitive Behavior Therapy. Our family members need to use their therapy time working on how to handle daily life and progress forward in their lives.

Having said that, if a person has only had one psychotic episode, there is a chance they won’t have another episode. Some doctors treat single psychotic episodes as such until time proves otherwise.


I wondered if CBT was the correct way to go. I think of CBT as a group thing. Is that correct or can we ask this new therapist to focus on CBT?

CBT focuses on challenging and changing cognitive distortions (such as thoughts beliefs and attitudes) and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. - from Wikipedia

Here’s an example.
My son became convinced that I was poisoning or medicating him through the meals and groceries I provided. He had stopped grocery shopping for himself because his audio hallucinations were that everyone in the grocery store was calling him names.

His therapist worked with him to suggest techniques he could use in the grocery stores to be able to shop for himself again. She didn’t try to convince him people weren’t calling him names, she focused on how he should behave in those instances.

My son’s therapy was all done one on one.


Wow, this is so great.

I’m apt to try to tell my wife that the things she hears aren’t real and the obvious fact that these people would never say such a thing. This is great for me to hear.

How SHOULD he handle the voices in the store.

I wonder if there’s way I can find other examples so I can emulate the same when these things happen.

Does your wife believe the voices are real?

CBT is considered best practice. The main focus is usually managing currect symptoms. A client may need to process past events, but it’s unlikely that past events - unless it drug use - caused the disorder/brain disease.

This is an interesting question you ask: what should I focus on. Do I understand rightly that you want to know if what is present or past(trauma) would be the best focus? It seems if you focus on your present struggles your therapist can use CBT or DBT or some other methods to help you function better. If I understand correctly, CBT seems to focus more on the external or behavioral change while DBT (dialectal behavior therapy) focuses what’s happening internally. Both can be necessary as changing your outside behavior affects how you may feel or think inside but instead understanding the Why? Involves the process of inner work with feelings and thoughts especially in relation to triggers from past trauma.
If you have a good therapist he or she can listen and learn from you; your concerns and how to best help you. May it go well.

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She probably does, they are undoubtedly real to her.

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Thanks, Julie. We were at the therapist and the nurse who dispenses meds today, 2 appointments.
We voiced concerns about the original diagnosis and then I saw the director of the facility.

She confirmed that often diagnoses during lockup are not complete that the original diagnosis of “brief psychotic disorder” on the schizophrenic spectrum may change over time. We will go from a high of 6Mg risperidone to .5 over the next month having only started 2 months ago. I asked the therapist to focus not only on CBT, but also to discuss issues from childhood and consider the possibility of bi-polar or PTSD. So feeling much better. Wish this were more scientific like being able to measure dopamine, etc… But this is the best we can do for now. You opened us up to DBT as in : Dialectical Behavior Therapy (DBT): What It Is & Purpose . We had to look it up. The saying “beggars can’t be choosers” comes to mind. I don’t think there’s that much of an offering in various types of therapy here. But as this article states perhaps we should take our time and shop around. Add to this is the language barrier and cultural difference (from another country).