Person with schizophrenia (ODS) experience various changes from their illness. These changes include ways of thinking (cognitive), ways of expressing feelings (emotional), and ways of interacting with other people around them (social). Around 70-80 percent of ODS experience cognitive decline compared to the normal population.
Impaired cognitive function in ODS causes obstacles in carrying out normal human functions in society, difficulty in solving problems, decreased success in rehabilitation programs, and inability to hold jobs. ODS cognitive function will affect their ability to function socially including their interpersonal skills as they often withdraw from any social contacts. Untreated cognitive and social functions in ODS will further exacerbate the existing schizophrenia and inhibit recovery.
However, these symptoms can be overcome with an approach by health workers and mental health observers to achieve recovery. Recovery is a condition when ODS have been treated and return to live their daily lives with their families in the community. ODS can achieve meaning in life, be appreciated, and achieve their life function without symptoms. One of the approaches of ODS recovery is psychosocial, which consists of cognitive remediation and psychoeducation.
Cognitive remediation is a behavioral exercise-based intervention that aims to improve cognitive processes such as attention, memory, executive function, social cognition, and metacognition that are common and long-lasting. The exercises can be given in the form of individual assignments, carried out in a group and guided by one or two instructors. Remediation material emphasizes focusing attention and memory, using available and inexpensive media such as newspaper clippings, recorded songs and news, shopping lists, picture cards and short stories. Routine and consistent cognitive remediation will be able to increase the cognitive abilities of ODS and have an impact on their social skills.
ODS also requires psychosocial interventions. One of them is psychoeducation. Psychoeducation is health education for patients that aims to overcome psychological problems. ODS and the caring family also experience various psychological problems so psychoeducation is very effective for ODS patients and their caring families. The psychoeducation can be done passively by providing information about schizophrenia, signs and symptoms, causes and ways of treating ODS at home using leaflets, email or websites. Meanwhile, active psychoeducation is in the form of counseling or providing health education individually or in groups by practicing practical skills such as real problem solving techniques, such as what families should do when ODS relapses. Psychoeducation is effective to prevent relapse, promote re-acceptance and improve compliance in taking medication.
The combination of cognitive remediation and psychoeducation in ODS is one of the ways health workers could do to handle ODS, especially to deal with psychosocial problems experienced by ODS. (*)
Author: Rizki Fitryasari