title: The Insight-Adherence-Abstinence triad: an integrated treatment focus for cannabis-using first-episode schizophrenia patients.
abstract: Insight-Adherence-Abstinence focused treatment for first episode of schizophrenia and schizoaffective patients is described using examples from clinical practice with 68 patients, 30 of whom have recent or active cannabis misuse. The treatment model is based on the unique characteristics of first-episode patients, who have little insight or experience with the relapses of chronic patients, demonstrate a great deal of denial, and frequently attribute their illness to cannabis. Treatment focuses on building adherence, abstinence, and insight during the first year of treatment in order to prevent repeated relapse and to optimize recovery. Interventions recognize the many needs of cannabis-using first-episode patients and therefore include supportive, cognitive-behavioral, behavioral, and motivational therapies, as well as skill building and psychoeducation.
authors.affiliation: Research Department, The Zucker Hillside Hospital/NSLIJ, Glen Oaks, New York 11004, USA. rmiller@lij.edu
authors.forename: Rachel
authors.initials: R
authors.lastname: Miller
authors.forename: Joanne McCormack
authors.initials: JM
authors.lastname: Caponi
authors.forename: Serge
authors.initials: S
authors.lastname: Sevy
authors.forename: Delbert
authors.initials: D
authors.lastname: Robinson
mesh_terms: D015928:Cognitive Behavioral Therapy / Q000379:methods*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D002189:Marijuana Abuse / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D009042:Motivation; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012559:Schizophrenia / Q000453:epidemiology*