Clinical Experience with the Friendship and Intimacy Module

The module has been in active use for the past 2 years at the Hollywood Mental Health Center’s Psychosocial Rehabilitation Program, the San Fernando Mental Health Center’s Wellness Program, the UCLA Psychiatric Rehabilitation Program, and the UCLA Neuropsychiatric Partial Hospital Program. It has been well received by patients; however, the caveat mentioned earlier regarding careful selection of professionals who are comfortable teaching the subject matter of the module in an active/directive mode is important. A variety of individuals from various mental health disciplines have led the module, including recovered consumers who have “graduated” from the module and serve as coleaders.

Susan was a 36-year-old, single woman with schizophrenia who lived with her parents. Her symptoms of psychosis had been in remission for over 6 years, and she faithfully took her medication. After more than 5 years as a volunteer, Susan subsequently was hired by a local charity that valued her work highly. She was sociable and extremely attractive,  well-dressed and -groomed,  and sexually active.  Her pattern was to meet men in bars and have frequent “one night stands,” much to the chagrin and worry of her parents. Many of the men she met took advantage of her naivete, and her desire to have a boyfriend and be involved in a close relationship.

She had several episodes of sexually transmitted diseases; fortunately, each was treatable and did not produce long-term sequelae.

Susan was referred to the UCLA Psychiatric Rehabilitation Program by her
psychiatrist to help her acquire better judgment in her choice of sexual partners.
Although initially querulous about how the Friendship and Intimacy Module might
assist her, Susan became highly motivated after attending the sessions on making
friends and dating. When the group got to the skills area on “go/no-go” sex signals,
Susan realized that she had been inadvertently encouraging men she met in bars by
allowing them to touch her hand and by leaning toward them with her face in close
proximity to theirs soon after beginning a conversation.

She also realized that there were nonverbal no-go signals she could give that would
limit her contacts with new male acquaintances to more mundane, nonflirtatious
conversation. As a result of participating in the module, Susan became much more
discriminating in her contacts and relationships with men, and developed a long-term,
intimate relationship with a man who genuinely cared about her and understood
that she had schizophrenia.

The skills she learned in the module enabled Susan to improve her social judg-
ment, interpersonal communication regarding romantic interests, and assertiveness
in taking control of interactions with men. After employing the friendship and dating
skill for 6 months, Susan met a man through a mutual friend and developed a com-
panionable relationship with him. They had much in common, and the conversation
and friendship skills Susan had learned enabled her to maintain and enjoy their time
together in the activities they had in common. Gradually, over a number of months,
steady dating and then a long-term relationship ensued. This time, Susan and her
boyfriend gave serious consideration before initiating a sexual relationship. Their
successful interaction was made possible by Susan’s continuing contacts with her
therapist, who offered refresher training on a number of the skills areas in the mod-


Alex Kopelowicz, M.D.a
Robert Paul Libermanb
Donald Stolar, PhDc

a Associate Professor of Psychiatry, David Geffen School of Medicine at UCLA
bProfessor of psychiatry at the University of California at Los Angeles
cDepartment of Psychiatry, University of California, Los Angeles,. Los Angeles, California



  1. Assalian, P., Fraser, R. R., Tempier, R., & Cohen, D. (2000). Sexuality and quality of life of patients with schizophrenia. International Journal of Psychiatry in Clinical Practice, 4, 29–33.
  2. Coverdale, J. H., & Turbott, S. H. (2000). Risk behaviors for sexually transmitted infections among men with mental disorders. Psychiatric Services, 51, 234–238.
  3. Crenshaw, T. L., & Goldberg, J. P. (1996). Sexual pharmacology: Drugs that affect sexual functioning. New York: Norton.
  4. Friedman, S., & Harrison, G. (1984). Sexual histories, attitudes and behavior of schizophrenic and “normal” women. Archives of Sexual Behavior, 13, 555–567.
  5. Goisman, R. (2001). Choices: An educational program for AIDS prevention. Boston: MMH Reseach Corporation.

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