I am posting this article from today's New York Times. The subject is anorexia, not schizophrenia, but the article brings up some interesting points that are relevant in handling schizophrenia. The Maudsley method, which I have heard about before, claims a better success rate than one-on-one therapy for anorexia.
The Maudsley Method is considered family based treatment, but claims it does not go into the family dynamics that may have led to the behavior on the first place. According to a parent: "The family method gave her the skills and confidence to approach her daughter’s anorexia the same way she would approach any other disease, whether flu or cancer. If you had medicine for your child, you wouldn’t let your child take half a dose,” Ms. Ranalli said. “I would say to her: ‘This is your food — this is your medicine. You’re not leaving the table before you eat it. We will get through this together. I will hold your hand and support you through this.’ ”
Unlike traditional approaches, the Maudsley method “says we don’t think the parents are to blame for the problem,” Dr. Le Grange said. “We think they’re part of the solution, and should be center stage.” Their job is to be calm, supportive and consistent. . . .Caregivers need to speak with one voice, he said; one parent cannot be telling the child to eat while the other says, “Just give her a break tonight. The parents need to be on the same page — not just the same page, but the same line and the same word and the same letter,” Dr. Le Grange said.
This all has a familiar ring to me because of tired assertion that anorexia is like a disease. It takes the same "parents are not to blame" assertion that you hear from drug companies, NAMI, and most psychiatrists. But when you look at what it is actually doing, it is sneaking in the idea that the parents are not on the same wavelength and it introduces the idea of low Expressed Emotion. It seems to work because the parents are not allowed to disagree about the approach and are forced to present a consistent, calm front to the person with anorexia.
Psychiatry could be as clever as the Maudsley method when it comes to schizophrenia if it really wanted to do something useful (I've been doubting this for years) and would be willing to drop the force feeding of drugs. If the truth is too unpalatable for most parents to swallow, it appears that they would be willing to buy the back door approach.