Many people still think of Sigmund Freud's couch when they think of therapy. Actually, therapeutic approaches developed over the last sixty years are very different from the older psychoanalytic therapy developed by Freud and his followers in the late nineteenth and early twentieth centuries. The therapies used today to help people develop their ability to cope with the challenges of schizophrenia are based on entirely different premises.

Less Emphasis on the Past

Freud believed that uncovering unconscious mental processes was crucial to making progress and that human psychology followed certain set paths or patterns. He stressed the dominance of past experiences as major influences on behavior.

Some therapists began advocating and teaching a different kind of therapy around the 1960s. This movement, which stressed treating people more as unique individuals who possessed significant potential to change their behavior, was based on the premise that people can gain self-insight and change without starting from childhood experiences.

Modern approaches are more practical. They teach patients how to handle and avoid everyday problems. Psychoanalysis, by contrast, requires years of delving into a person's childhood. Most important, it does not help patients with schizophrenia, and research has demonstrated that it might cause some patients to get even worse and have more symptoms.

Individual Psychotherapy

After a patient's psychotic symptoms are under control, she may benefit from private meetings with a mental health care professional. This therapist may be a psychiatrist with a medical degree, a psychologist with a doctorate, a psychiatric social worker or psychiatric nurse with a master's degree, or a licensed counselor with a master's degree. Whoever it is, it is important that the therapist is well-trained and sensitive to the patient's psychological state.

Individual therapy offered in a supportive environment that stresses pragmatic, reality-based insights can be of tremendous benefit to many individuals affected by mental illnesses, including schizophrenia. It is important that the consumer trusts the therapist and feels comfortable talking to him.

Sharing thoughts and concerns with a trusted outsider can help a person with schizophrenia gain understanding and perspective about the feelings and events affecting her life. In time, these sessions can lead to greater insight and self-confidence. With the help of a skilled therapist, a person can improve her ability to distinguish between reality and the distorted thoughts of schizophrenia.

Behavioral Therapy

Another movement that has influenced current therapies is behavioral or conditioning therapy. It is based on experimental principles of learning. It seeks to change undesirable behavior and replace it with desirable habits. It seems coldly scientific to some people, but it includes techniques that are very useful for improving behavior, coping skills, and the ability to function day-to-day.

The best therapists know enough to tailor therapy to an individual's needs and ability to respond. They can use techniques from a variety of therapeutic approaches to solve problems and improve coping skills. The format and goal of therapy may change over time to adjust to the changes in and the needs of the patient.

One area where therapy is demonstrating great potential for improving lives is in the treatment of young people at risk of developing mental illnesses. Employing therapy as a means of primary prevention in children and adolescents is an important goal of the mental health community.