Medications and doses should be left unchanged for six months after the acute phase while the patient stabilizes. Once the acute symptoms have diminished, treatment should focus on creating a long-term stable environment that will minimize the chance of relapse. The therapist or other treatment provider (case manager, community worker) should work jointly with the patient to establish reasonable and achievable goals. The quality of the patient’s environment including financial situation, living quarters, neighborhood, significant others, family, etc., should be addressed. Even small interventions can be critical in reducing stress, thereby reducing the risk of relapse. Mobilizing community supports is essential, even though many afflicted individuals remain isolated and reject attempts at outreach.
Because schizophrenia can have a devastating effect on the family as well as the patient, family therapy is warranted. The goals of therapy are to help gain understanding and acceptance of the illness and actively involve the family in improving the patients functioning. Family dynamics should be explored to identify behaviors that may exacerbate psychotic symptoms (e.g., high emotional expressivity) or undermine medication compliance.