[Clinical management and rehabilitation of the treatment refractory patient: conceptual foundations and outcome data].
Despite advances in psychopharmacology for people with schizophrenia, many patients remain too disabled to be discharged from public psychiatric facilities. This paper describes the development of a public-private partnership which led to the creation of a specialized, intensive behavioral rehabilitation program for schizophrenia patients who were considered to be treatment-refractory at public hospitals. The essential elements of this treatment program are described, along with the philosophical bases of its treatment. Outcome data are discussed to emphasize the point that when evidence-based treatment is implemented with this population, outcomes can be positive in most cases, and therefore, the number of "treatment-refractory" patients is actually less than is estimated based on response to medication alone.
Silverstein
Steven M
SM
Center for Cognitive Medicine, University of Illinois at Chicago, Chicago, IL, USA.
Hatashita-Wong
Michi
M
Wilkniss
Sandra
S
Lapasset
Jerôme
J
Bloch
Andrew
A
McCarthy
Richard
R
D006801:Humans; D007326:Institutionalization; D016730:Program Development; D015397:Program Evaluation; D012559:Schizophrenia / Q000188:drug therapy / Q000534:rehabilitation* / Q000628:therapy*; D017211:Treatment Failure