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Early recognition of psychoses and bipolar disorders

What therapies can I make use of?

The therapy aims to make you feel “normal” again as quickly as possible, i.e. you no longer have psychic problems and can again go about your desired activities without any problems. This is not possible within a few days in most persons afflicted. You should expect that you will have to make use of this help for a certain time.

The type of therapy is guided by your individual set of problems and your life circumstances and will be coordinated and discussed with you and if applicable with your family. Understandably, there is not “the” therapy but various therapies that are compiled and combined for you personally in accordance with your individual requirements. These are mostly all offered in the outpatients department, sometimes however also in special day clinics for young persons and young adults. In any case, you will be given advice about possible further therapies. Possible forms and contents of therapies for persons with risks of psychoses are summarized below.

Forms and contents of the possible therapies

Clarification / psychiatric education

  • For many, teaching units in schools or the visit to a psychosis seminar offer a first orientation. Or it is worthwhile visiting a psychiatric education course – in cases of doubt jointly with relatives.

Psychotherapy

  • In times of greater uncertainty, psychotherapeutic help can be necessary so that the person afflicted can reorient and find himself / herself again. Important is the personal fit. Depending on the orientation, cognitive, action-oriented strategies (cognitive behaviour therapy), biographical understanding and emotional elaboration of conflicts (psychodynamic processes) or the joint struggle for understanding and better conflict solution strategies (family therapy) prevail.
  • If a simultaneous addiction disorder exists you should take part in a special addiction therapy. This can take place in a group or individually. This is an absolute necessity for improving the prognosis!

Psychological training programmes

  • Many persons afflicted reported so-called cognitive problems, i.e. concentration disorders, memory problems, difficulties in paying attention etc. For improving these problems, there are special training programmes, e.g. the so-called “Metacognitive Training”.
  • For improving social competences i.e. to strengthen self-confidence in social situations, the so-called “social competence training” exists.

Pharmacological intervention

  • Pharmacological treatments are used according to the prevailing symptoms: antidepressants for depression and antipsychotic drugs for high-risk patients with already weakened psychotic symptoms. The decision is made together with the person afflicted after a detailed

Professional rehabilitation

  • Some persons afflicted have already had professional problems beforehand, before they come into therapy for the first time, i.e. they no longer or only sporadically go to school or have problems in training and profession. Correspondingly, it is necessary to offer help on site.

Social measures

  • Some persons afflicted already have problems with finances or in their housing circumstances, so that here too a support is necessary.

Treatment at home (“Assertive Community Treatment”, ACT)

  • Many persons affected have problems accepting help in the early stage. For this, so-called Assertive Community Treatment Teams exist, which can also offer a treatment in one’s own environment.

Work with relatives

  • Work with relatives is particularly important in the case of persons with a risk of psychosis since the relatives must be informed just as much about psychoses as the person afflicted him / herself. They should also be recommended to take part in support groups for relatives and to contact associations of relatives.
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