PubMed HealthSearch

Biomedical subjects

B P Karon

Publications and source records attributed to B P Karon.

4 recordsLinked to original sources

The fear of understanding schizophrenia and the avoidance of the acutely disturbed student.

Although it is generally believed that a treatment that is more effective than its alternatives will be used, psychological treatments for schizophrenic and other psychotic reactions have been avoided despite the evidence of their effectiveness from the time of "moral treatment" to the present. Less effective (or even destructive) treatments have been seized upon, in part because they do not require understanding patients. Understanding them means facing facts about ourselves, our families, and our society that we do not want to know, or, in the case of repressed feelings and experiences, do not want to know again. This reluctance to understand is particularly tragic in the case of the acutely disturbed college student, whose crisis may lead either to reorganization at a higher level of functioning and growth or to a wasted life. The central role of terror in producing symptoms and the genesis and handling of symptoms, including delusions and hallucinations, are briefly discussed.

Fear

Psychotherapy with schizophrenics requires relevant training.

Secondary sources continue to cite a one-page preliminary note about the Michigan State Psychotherapy Project, ignoring fuller reports in print. Relevant experience and training are critical to quality control of psychotherapy in schizophrenia research. This investigation is unique in that "experienced" meant that the therapist had worked over 10 years specifically with schizophrenics, poor patients, and black patients. These relevantly experienced therapists supervised inexperienced therapists. Evaluations were "blind," and thought disorder was objectively measured. Psychotherapy produced better overall functioning, less thought disorder, and shorter hospitalization, particularly in the long run, than medication. Adjunctive medication facilitated behavioral control, but slowed change in the thought disorder.

Clinical Competence