Hostname: page-component-6bb9c88b65-k72x6 Total loading time: 0 Render date: 2025-07-26T03:02:07.546Z Has data issue: false hasContentIssue false
  • English
  • Français

Controversies and Growing Points in Cognitive-Behavioural interventions for People with Schizophrenia

Published online by Cambridge University Press:  16 June 2009

Max Birchwood  and
Geoff Shepherd
Max Birchwood
Affiliation:
All Saints Hospital, Birmingham
Geoff Shepherd
Affiliation:
Fulbourn Hospital, Cambridge
Get access Rights & Permissions [Opens in a new window]

Extract

The growing “family” of cognitive-behavioural interventions has made impressive strides in the management of schizophrenia over the last decade. This paper critically reviews the advances that have been made and examines some of the controversies and difficulties encountered in the application of this approach and suggests areas for future growth and research. Future developments in family interventions, early intervention, the management of hallucinations and the potential utility of a form of psychotherapy to treat secondary depression and prevent suicide, are covered in depth. Service structures to integrate these interventions, their timing and duration are considered. It is suggested that the marriage of case management and psychosocial interventions in particular is now overdue.

Information

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 20 , Issue 4 , October 1992 , pp. 305 - 342
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1992

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Alford, G. S., Fleece, L. and Rothblum, E. (1982). Hallucinatory-delusional verbalisations: modification in a chronic schizophrenic with self-control and cognitive restructuring. Behaviour Modification 6, 421–435.CrossRefGoogle Scholar
Allen, C. I., Gillespie, C. R. and Hall, J. N. (1989). A comparison of practices, attitudes and interactions in two established units for people with psychiatric disability. Psychological Medicine 19.Google ScholarPubMed
Bachrach, L. L. (1989) Case management: towards a shared definition. Hospital and Community Psychiatry 40, 883–884.Google Scholar
Barnes, T. R., Curson, D. A., Liddle, P. F. and Patel, M. (1989). The nature and prevalence of depression in chronic schizophrenic inpatients. British Journal of Psychiatry 154, 486–491.CrossRefGoogle Scholar
Barrelet, L., Ferrero, F., Szigethgy, L., Giddey, C., Pellizer, G. (1990). Expressed emotion and first admission schizophrenia: a replication in a French cultural environment. British Journal of Psychiatry 153, 532–542.Google Scholar
Barrowclough, C. and Tarrier, N. (1990). Social functioning in schizophrenic patients. I: The effects of expressed emotion and family intervention. Social Psychiatry and Psychiatric Epidemiology 25, 125–129.CrossRefGoogle ScholarPubMed
Bennett, D. H. (1980). The chronic psychiatric patient today. Journal of the Royal Society of Medicine 73, 301–303.CrossRefGoogle ScholarPubMed
Bentall, R. (1992). Reconstructing psychopathology. The Psychologist 5, 61–66.Google Scholar
Bentall, R. P., Jackson, H. F. and Pilgrim, D. (1988). Abandoning the concept of schizophrenia: some implications of validity arguments of psychological research into psychotic phenomena. British Journal of Clinical Psychology 27, 303–324.CrossRefGoogle ScholarPubMed
Berkowitz, R., Shavit, N. and Leff, J. P. (1990). Educating relatives of schizophrenic patients. Social Psychiatry and Psychiatric Epidemiology 25, 216–320.CrossRefGoogle ScholarPubMed
Birchwood, M., (1991). A paradigm for psychotherapy for individuals with schizophrenia: the individual-illness interaction. Bulletin of the Royal College of Psychiatrists, Supplement 4, 38–40.Google Scholar
Birchwood, M. (1992). Practice review: early intervention in schizophrenia. British Journal of Clinical Psychology (in press).Google Scholar
Birchwood, M. and Chadwick, P. (1992). The omnipotence of voices: a cognitive approach to hallucinations. Invited article British Journal of Psychiatry (in press).Google Scholar
Birchwood, M., Cochrane, R., Macmillan, J. F., Copestake, S. and Kucharska, J. (1992). The influence of ethnicity and family structure on relapse in first episode schizophrenia. British Journal of Psychiatry (in press).CrossRefGoogle Scholar
Birchwood, M., Hallett, S. and Preston, M. (1988). Schizophrenia: An Integrated Approach to Research Treatment. Harlow, Essex: Longmans.Google Scholar
Birchwood, M., Macmillan, J. F. and Smith, J. (1992). Early intervention. In Birchwood, M. and Tarrier, N. (Eds). Innovations in the Psychological Management of Schizophrenia. Chichester: Wiley.Google Scholar
Birchwood, M., Mason, R. and Healy, J. (1992). Depression, demoralisation and control over psychotic illness. In submission.Google Scholar
Birchwood, M. and Smith, J. (1987). Schizophrenia in the family. In Orford, J. (Ed.) Coping with Disorder in the Family. London: Croom-Helm.Google Scholar
Birchwood, M., Smith, J., Cochrane, R., Wetton, S. and Copestake, S. (1990). The social functioning scale: the development and validation of a scale of social adjustment for use in family intervention programmes with schizophrenic patients. British Journal of Psychiatry 157, 853–859.CrossRefGoogle ScholarPubMed
Birchwood, M., Smith, J., Macmillan, J. F., Hogg, B., Prasad, R., Harvey, C. and Bering, S. (1989). Predicting relapse in schizophrenia: the development and implementation of an early signs monitoring system using patients and families as observers. Psychological Medicine 19, 649–656.CrossRefGoogle ScholarPubMed
Birchwood, M. and Tarrier, N. (1992). Innovations in the Psychological Management of Schizophrenia. Chichester: Wiley.Google Scholar
Bleuler, M. (1978). The Schizophrenic Disorders: Long Term Patient and Family Studies. (Clemens, S. M. trans.) New Haven: Yale University Press.Google Scholar
Brewin, C. R., MacCarthy, B., Duda, K and Vaughn, C. E. (1991). Attribution and expressed emotion in the relatives of patients with schizophrenia. Journal of Abnormal Psychology 100, 546–554.CrossRefGoogle ScholarPubMed
Brier, A. and Strauss, J. S. (1983). Self control in psychiatric disorders. Archives of General Psychiatry 40, 1141–1145.CrossRefGoogle Scholar
Brown, G. and Harris, T. (1978). The Social Origins of Depression. London: Cutstork Publications.Google ScholarPubMed
Bulow, H., Oei, T. P. S. and Pinkey, B. (1979). Effects of contingent social reinforcement with delusional chronic schizophrenic men. Psychological Reports 44, 659–666.CrossRefGoogle ScholarPubMed
Caldwell, J. and Gottesman, I. (1990). Schizophrenics kill themselves too. Schizophrenia Bulletin 16, 571–590.CrossRefGoogle ScholarPubMed
Carpenter, W. T. and Strauss, J. S. (1992). The prediction of outcome in schizophrenia: eleven year follow-up of the Washington IPSS cohort. Journal of Nervous and Mental Health Disease 179, 517–525.CrossRefGoogle Scholar
Carr, B. (1988). Patients' techniques for coping with schizophrenia: an exploratory study. British Journal of Medical Psychology 61, 339–352.CrossRefGoogle ScholarPubMed
Chadwick, P. and Lowe, F. (1990). The measurement and modification of delusional beliefs. Journal of Consulting Clinical Psychology 58, 225–232.CrossRefGoogle ScholarPubMed
Chapman, J. (1966). The early symptoms of schizophrenia. British Journal of Psychiatry 112, 225–251.CrossRefGoogle ScholarPubMed
Clements, K. and Turpin, G. (1992). Vulnerability models and schizophrenia: the assessment and prediction of relapse. In M. Birchwood and N. Tarrier. Innovation in the Psychological Management of Schizophrenia. Chichester: Wiley.Google Scholar
Clifford, P., Charman, A., Webb, Y. and Best, S. (1991). Planning for community care: long-stay populations of hospitals scheduled for rundown or closure. British Journal of Psychiatry 158, 190–196.CrossRefGoogle ScholarPubMed
Crow, T. J. (1990). The continuum of psychosis and its genetic origins. British Journal of Psychiatry 156, 788–797.CrossRefGoogle ScholarPubMed
Curson, D. A., Barnes, T. R. E., Bamber, R. W., Platt, S. D., Hirsch, S. R. and Duffy, J. D. (1985). Long term depot maintenance of chronic schizophrenic outpatients. British Journal of Psychiatry 146, 464–480.CrossRefGoogle Scholar
Curson, D. A., Patel, M., Liddle, P. F. and Barnes, T. R. E. (1988). Psychiatric morbidity of a long stay hospital population with chronic schizophrenia and implications for future community care. British Medical Journal 297, 819–822.CrossRefGoogle ScholarPubMed
Cutler, D. L., Tatum, E. and Shore, J. H. (1987). A comparison of schizophrenic patients in different community support treatment approaches. Community Mental Health Journal 23, 103–113.CrossRefGoogle ScholarPubMed
Davies, M. A., Bromet, E. J., Schulz, S. C., Dunn, L. D. and Morganstern, M. (1989). Community adjustment of chronic schizophrenic patients in urban and rural settings. Hospital and Community Psychiatry 40, 824–830.Google ScholarPubMed
Department of Health (1989). Caring for People: Community Care in the Next Decade and Beyond. Cm 849. London: HMSO.Google Scholar
Department of Health (1990). Community Care in the Next Decade and Beyond: Policy Guidance. London: HMSO.Google Scholar
Donlon, P. T. and Blackler, K. H. (1975). Clinical recognition of early schizophrenic decompensation. Disorders of the Nervous System 36, 323–330.Google ScholarPubMed
Drake, R. E. and Cotton, P. G. (1986). Depression, hopelessness and suicide in chronic schizophrenia. British Journal of Psychiatry 148, 554–559.CrossRefGoogle ScholarPubMed
Estroff, S. E. (1989). Self identity and subjective experiences of schizophrenia: in search of the subject. Schizophrenia Bulletin 15, 189–196.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Boyd, J. L., McGill, C. W. (1985). Family management in the prevention of morbidity of schizophrenia: clinical outcome of a two year longitudinal study. Archives of General Psychiatry 42, 887–896.CrossRefGoogle ScholarPubMed
Falloon, I. R. H., Krekorian, H., Shanahan, W. J., Laporta, M. and McLees, S. (1990). The Buckingham Project: a comprehensive mental health service based on behavioural psychotherapy. Behavioural Change 7, 51–57.CrossRefGoogle Scholar
Falloon, I. R. H. and Talbot, R. E. (1981). Persistent auditory hallucinations: coping mechanisms and implications for management. Psychological Medicine 11, 329–339.CrossRefGoogle ScholarPubMed
Fisher, G., Landis, D. and Clark, K. (1988). Case management service provision and client change. Community Mental Health Journal 24, 134–142.CrossRefGoogle ScholarPubMed
Foulds, G. W. (1976). The Hierarchical Nature of Personal Illness. London: Academic Press.Google Scholar
Fowler, D. and Morley, S. (1989). The cognitive-behavioural treatment of hallucinations and delusions: a preliminary study. Behavioural Psychotherapy 17, 267–282.CrossRefGoogle Scholar
Franklin, J. L., Solovitz, B., Mason, M., Clemons, J. R. and Miller, G. E. (1987). An evaluation of case management. American Journal of Public Health 77, 74–78.CrossRefGoogle ScholarPubMed
Garety, P. A. (1988). Housing. In Lavender, A. and Holloway, F. (Eds). Community Care in Practice. Chichester: Wiley.Google Scholar
Garety, P. A. and Morris, I. (1984). A new unit for long-stay psychiatric patients: organisation, attitudes and quality of care. Psychological Medicine 14, 183–192.CrossRefGoogle ScholarPubMed
Green, W. P., Glass, A. and O'Callaghan, M. (1979). Some implications of abnormal hemisphere interaction in schizophrenia. In Gruzellier, J. and Flor-Henry, P. (Eds). Hemisphere Asymmetrics of Function and Psychopathology. Amsterdam: Elsevier.Google Scholar
Grosser, R. and Vine, P. (1991). Families as advocates for the mentally ill: a survey of characteristics and service needs. American Journal of Orthopsychiatry 61, 282–289.CrossRefGoogle ScholarPubMed
Harding, C. M., Brooks, G. W., Ashikeya, T., Strauss, J. S. and Brier, A. (1987). The Vermont longitudinal study of persons with severe mental illness II. Long term outcome of subjects who retrospectively met DSM-III criteria for schizophrenia. American Journal of Psychiatry 144, 727–735.Google ScholarPubMed
Heinrichs, D., Cohen, B. P. and Carpenter, N. T. (1985). Early insight and the management of schizophrenic decompensation. Journal of Nervous and Mental Disease 173, 133–136.CrossRefGoogle ScholarPubMed
Herz, M. and Melville, C. (1980). Relapse in schizophrenia. American Journal of Psychiatry 137, 801–812.Google ScholarPubMed
Hirsch, S. R. and Jolley, A. G. (1989). The dysphoric syndrome in schizophrenia and its implications for relapse. British Journal of Psychiatry (suppl 5), 46–50.CrossRefGoogle Scholar
Hirsch, S. R., Jolley, A. G., Barnes, T. R. E., Liddle, P. F., Curson, D. A., Patel, A., York, A., Berru, S. and Patel, M. (1989). Dysphoric and depressive symptoms in chronic schizophrenia. Schizophrenia Research 2, 259–264.CrossRefGoogle ScholarPubMed
Hodgins, S., Cyr, M. and Gaston, L. (1990). Impact of supervised apartments on the functioning of mentally disordered adults. Community Mental Health Journal 26, 507–516.CrossRefGoogle ScholarPubMed
Hogarty, G. E., Anderson, C. M., Reiss, D. J., Korblinth, S. J., Greenwald, D. P., Ulrich, R. F. and Carter, M. (1991). Family psycho-education, social skills training, and maintenance chemotherapy in the after care treatment of schizophrenia. Archives of General Psychiatry 48, 340–347.CrossRefGoogle Scholar
Holloway, F. (1988). Day care and community support. In Lavender, A. and Holloway, F. (Eds). Community Care in Practice. Chichester: Wiley.Google Scholar
Hoult, J. (1986). Community care of the acutely mentally ill. British Journal of Psychiatry 149, 137–144.CrossRefGoogle ScholarPubMed
Huq, S. F., Gartey, P. and Hemsley, D. (1988). Probabilistic judgements in deluded and non-deluded subjects. Quarterly Journal of Experimental Psychology 40A, 801–812.CrossRefGoogle Scholar
Johnson, D. A. W. (1981). Studies of depressive symptoms in schizophrenia. British Journal of Psychiatry 139, 89–101.CrossRefGoogle ScholarPubMed
Johnson, D. A. W. (1988). The significance of depression in the prediction of relapse in chronic schizophrenia. British Journal of Psychiatry 152, 320–323.CrossRefGoogle ScholarPubMed
Jolley, A. G., Hirsch, S. R. and McRink, A. (1989). Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical outcome at one year. British Medical Journal 298, 985–990.CrossRefGoogle ScholarPubMed
Jolley, A. G., Hirsch, S. R., Morrison, G., McRink, A. and Wilson, L. (1990). Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenia outpatients: clinical and social outcome at two years. British Medical Journal 301, 837–842.CrossRefGoogle ScholarPubMed
Kanter, J. (1989). Clinical case management: definition, principles components. Hospital and Community Psychiatry 40, 361–368.Google ScholarPubMed
Knight, A. and Hirsch, S. R. (1981). Revealed depression and drug treatment of schizophrenia. Archives of General Psychiatry 40, 893–896.Google Scholar
Kraepelin, E. (1919). Dementia Praecox (transl. Barclay, ) Edinburgh: Livingstone.Google Scholar
Lam, D. (1991). Psychosocial family intervention studies in schizophrenia: a review of empirical studies. Psychological Medicine 21, 423–441.CrossRefGoogle ScholarPubMed
Leff, J., Tress, K. and Edwards, B. (1988). Psychological medicine. The clinical course of depressive symptoms in schizophrenia. Schizophrenia Research 1, 25–30.CrossRefGoogle Scholar
Leff, J., Wig, N. N., Bedi, H., Menon, D. K., Kuipers, L., Korten, A., Ernberg, G., Day, R., Sartorius, N. and Joblewsky, A. (1990). Relatives' expressed emotion and the course of schizophrenia in Chandigarh. British Journal of Psychiatry 156, 351–356.CrossRefGoogle ScholarPubMed
Lin, K. and Kleinman, A. M. (1988). Psychopathology and clinical course of schizophrenics: a cross cultural perspective. Schizophrenia Bulletin 14, 555–568.CrossRefGoogle ScholarPubMed
Linn, M. W., Caffey, E. M., Klett, J., Hogarty, G. E. and Lamb, H. R. (1979). Day treatment and psychotropic drugs in the aftercare of schizophrenic patients. Archives of General Psychiatry 36, 1055–1066.CrossRefGoogle ScholarPubMed
McCandless-Glincher, L., McKnight, S., Hamera, E., Smith, B. L., Peterson, K., Plumlee, A. A. (1986). Use of symptoms by schizophrenics to monitor and regulate their illness. Hospital and Community Psychiatry 37, 929–933.Google Scholar
McGlashen, T. H. (1988). A selective review of recent North American long term follow-up studies of schizophrenia. Schizophrenia Bulletin 515–542.CrossRefGoogle Scholar
McGlashan, T. H. and Carpenter, N. T. (1976). An investigation of the post psychotic depressive syndrome. American Journal of Psychiatry 133, 14–19.Google Scholar
McGlashan, T. H. and Carpenter, N. T. (1981). Does attitude towards psychosis relate to outcome? American Journal of Psychiatry 138, 797–801.Google Scholar
McGlashan, T. H., Levy, S. T. and Carpenter, W. T. (1975). Integration and sealing over: clinically distinct recovery styles from schizophrenia. Archives of General Psychiatry 32, 1269–1272.CrossRefGoogle ScholarPubMed
Macmillan, J. F., Crow, T. J., Johnson, A. L. and Johnstone, E. C. (1986). The Northwick Park first episodes of schizophrenia study. British Journal of Psychiatry 148, 128–133.CrossRefGoogle Scholar
Marzillier, J. S. and Birchwood, M. (1981). Behaviour therapy of schizophrenic disorders. In Michelson, L.Hessen, M. and Ballack, A. (Eds). Future Perspectives in Behaviour Therapy. New York: Plenum.Google Scholar
Miller, F., Dworkin, J., Ward, M., Barone, D. (1990). A preliminary study of unresolved grief in families of seriously mentally ill patients. Hospital and Community Psychiatry 41, 1321–1325.Google ScholarPubMed
Morris, I. (1991). Residential care. In Bennett, D. H. and Freedom, H. L. (Eds). Community Psychiatry. London: Churchill Livingstone.Google Scholar
O'Driscoll, C., Marshall, J. and Reed, J. (1990). Chronically ill patients in a district general hospital unit: a survey and two-year follow-up in an inner-London health district. British Journal of Psychiatry 157, 694–702.CrossRefGoogle Scholar
Offenkrantz, W. C. (1962). Multiple somatic complaints as a precursor of schizophrenia. American Journal of Psychiatry 119, 258–259.CrossRefGoogle ScholarPubMed
Olfson, M. (1990). Assertive community treatment: an evaluation of the experimental evidence. Hospital and Community Psychiatry 41, 634–641.Google ScholarPubMed
Pilling, S. (1988). Work and the continuing care client. In Lavender, A. and Holloway, F. (Eds). Community Care in Practice. Chichester: Wiley.Google Scholar
Roy, A. (1981). Depression in the course of chronic undifferentiated schizophrenia. Archives of General Psychiatry 38, 296–297.CrossRefGoogle ScholarPubMed
Roy, A., Thompson, R. and Kennedy, S. (1983). Depression in chronic schizophrenia. British Journal of Psychiatry 142, 465–470.CrossRefGoogle ScholarPubMed
Ryan, P., Ford, R. and Clifford, P. (1991). Case Management and Community Care. London: Routledge.Google Scholar
Scheff, T. J. (1975). Schizophrenia as ideology. In Scheff, T. J. (Ed). Labelling Madness. Engelwood Cliffs, N.J.: Prentice Hall.Google Scholar
Segal, S. P. and Aviram, V. (1978). The Mentally Ill in Community Based Sheltered Care: A Study of Community Care and Social Integration. New York: Wiley.Google Scholar
Shepherd, G. (1984). Institutional Care and Rehabilitation. London/New York: Longman.Google Scholar
Shepherd, G. (1990). Case management. Health Trends 22, 59–63.Google ScholarPubMed
Shepherd, G. (1991a). Psychiatric rehabilitation for the 1990s. In Watts, F. N. and Bennett, D. H. (Eds). Theory and Practice of Psychiatric Rehabilitation. Chichester: Wiley.Google Scholar
Shepherd, G. (1991b). Day treatment and care. In Bennett, D. H. and Freeman, H. L. (Eds). Community Psychiatry. London: Churchill Livingstone.Google Scholar
Shepherd, G. and Richardson, A. (1979). Social skills and beyond: environments for the care of chronic problems. Behavioural Psychotherapy 7, 31–38.CrossRefGoogle Scholar
Shepherd, G. and Singh, K. (1992). Zur praktischen Bedeutung des EE-Konzepts fur die Rehabilitation (The practical importance of the concepts of expressed emotion in rehabilitation). Psychatric Praxis (in press).Google Scholar
Shepherd, M., Watt, D. and Falloon, I. (1989). The natural history of schizophrenia: a five year follow-up study. Psychological Medicine (Monog. Supp 15).Google Scholar
Siris, S. G. (1991). Diagnosis of secondary depression in schizophrenia. Schizophrenia Bulletin 17, 75–98.CrossRefGoogle ScholarPubMed
Smith, J. and Birchwood, M. (1990). Relatives and patients as partners in the management of schizophrenia. British Journal of Psychiatry 156, 654–660.CrossRefGoogle ScholarPubMed
Soskis, D. A. and Bowers, M. B. (1969). The schizophrenia experience: a follow-up study of attitude and post-hospital adjustment. Journal of Nervous and Mental Disease 149, 443–449.CrossRefGoogle Scholar
Stein, L. I. and Test, M. (1980). Alternatives to mental hospital treatment: conceptual model; treatment programme and clinical evaluation. Archives of General Psychiatry 37, 392–397.CrossRefGoogle ScholarPubMed
Stein, L. I. and Test, M. (1985). The Training in Community Living Model: A Decade of Experience. San Francisco: Jossey Bass.Google Scholar
Strachan, A. M., Feingold, D., Goldstein, M. J., Miklowitz, D. J. and Neuchterlein, K. H. (1989). Is expressed emotion an index of a transaction process? Family Process 78, 169–181.CrossRefGoogle Scholar
Strauss, J. S. (1989). Subjective experiences of schizophrenia: towards a new dynamic-II. Schizophrenia Bulletin 15, 179–188.CrossRefGoogle Scholar
Subotnik, K. L. and Neuchterlein, K. H. (1988). Prodromal signs and symptoms of schizophrenic relapse. Journal of Abnormal Psychology 97, 405–412.CrossRefGoogle ScholarPubMed
Tarrier, N. (1987). An investigation of residual psychotic symptoms in discharged schizophrenic patients. British Journal of Clinical Psychology 26, 141–143.CrossRefGoogle ScholarPubMed
Tarrier, N. (1991). Some aspects of family interventions in schizophrenia I: adherence to intervention programmes. British Journal of Psychiatry 159, 475–480.CrossRefGoogle ScholarPubMed
Tarrier, N., Harwood, S., Yusopoff, L., Beckett, R. and Baker, A. (1990). Coping strategy Enhancement (CSE): a method of treating residual schizophrenic symptoms. Behavioural Psychotherapy 18, 283–293.CrossRefGoogle Scholar
Taylor, K. E. and Perkins, R. E. (1991). Identity and coping with mental illness in long-stay rehabilitation. British Journal of Clinical Psychology 30, 73–85.CrossRefGoogle Scholar
Thompson, K. S., Griffith, E. E. H. and Leaf, P. J. (1990). A historical review of the Madison model of community care. Hospital and Community Psychiatry 41, 625–634.Google ScholarPubMed
Van Putten, T. and May, P. R. A. (1978). A “kinetic depression” in schizophrenia. Archives of General Psychiatry 35, 1101–1107.CrossRefGoogle Scholar
Warner, R. W., Taylor, D., Powers, M. and Hyman, J. (1989). Acceptance of the mental illness label by psychotic patients: effects on functioning. American Journal of Orthopsychiatry 59, 398–409.CrossRefGoogle ScholarPubMed
Watts, F. N., Powell, E. G. and Austin, S. V. (1973). The modification of abnormal beliefs. British Journal of Medical Psychology 46, 359–363.CrossRefGoogle ScholarPubMed
Zubin, J., Magaziner, J. and Steinhaur, R. (1983). The metamorphosis of schizophrenia: from vulnerability to chronicity. Psychological Medicine 13, 551–571.CrossRefGoogle ScholarPubMed
Zubin, J. and Spring, B. (1977). Vulnerability: a new view of schizophrenia. Journal of Abnormal Psychology 86, 260–266.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.