Combining Cognitive Therapy and Pharmacotherapy for Schizophrenia

Abstract

Cognitive therapy (CT) is now recognized as an effective intervention for schizophrenia in clinical guidelines developed in the United States (APA, 2006; Lehman et al., 2004) and Europe (e.g., National Institute of Clinical Excellence, 2002). However, empirical studies of CT for schizophrenia, cited as the evidence base for these recommendations, have been conducted solely with patients treated with concurrent medication. It has been a priority in some studies to enhance collaboration with the use of medication and insight into the illness for the individual patient (Kemp, Hayward, Applewhaite, Everitt, & David, 1996); and in most studies, such collaboration has been an integral part of the CT intervention. This article discusses potential interactions between medication and therapy, briefly outlines commonly used medication regimens for schizophrenia, details possible methods to improve adherence to pharmacotherapy, and explores issues encountered in collaboration in combined pharmacotherapy and CT. Finally, we discuss strategies for managing situations in which clients do not want to take medication.