Dr. Talbot is fairly certain that Kevin meets the diagnostic criteria for schizophrenia. His hallucinations and delusions are evidence that he is experiencing psychotic behavior. Dr. Talbot believes that his behavior change in high school, from being a popular student to becoming reclusive, was the first indication of the illness.

At 25, Kevin is just about at the average age for the first episode of schizophrenia. Kevin’s cousin Natalie has given Dr. Talbot even more evidence that Kevin is schizophrenic. Her father, Kevin’s uncle, was hospitalized for psychiatric symptoms that sound a lot like schizophrenia.

In order to provide the most comprehensive treatment, Dr. Talbot assembles a team of clinicians. She assigns Kevin to a psychiatrist who will prescribe and monitor his medications. She also introduces Kevin to a case manager who will help figure out whether Kevin needs financial or housing assistance.

For the next few weeks, Kevin will be in the hospital and will attend group meetings as well as individual meetings with Dr. Talbot. In the group meetings, Kevin will learn more about schizophrenia and how to avoid relapse. Individual psychotherapy will give Kevin an opportunity to talk about his personal experience with schizophrenia and learn how to live with the illness.

All the clinicians—Dr.Talbot, the psychiatrist, the case manager, and the psychologist will meet regularly to discuss Kevin’s treatment and progress. Dr. Talbot will offer Natalie and the rest of Kevin’s family information about schizophrenia and suggest support groups where they can learn more about living with someone who suffers from the illness.

Having an experienced, supportive treatment team in place is the best assurance that Kevin will recover as quickly and completely as possible.

History of Treatment

Before prescription medications, treatment for schizophrenia was primitive at best. Patients who lacked financial resources were usually confined to asylums and often treated with inhumane and degrading methods. Patients with schizophrenia were sometimes bound in straitjackets or subjected to radical brain surgery. Some patients were treated with fever therapy in which high fevers were induced in an attempt to alleviate psychotic symptoms. Others were subjected to electroconvulsive therapy (ECT) or simply tied to their beds. Although patients who came from wealthy families were able to obtain more humane treatment in private hospitals,  treatment options were few until the introduction of antipsychotic medication in the 1950s.

Heather Barnett Veague, Ph.D.
Heather Barnett Veague attended the University of California, Los Angeles, and received her Ph.D. in psychology from Harvard University in 2004. She is the author of several journal articles investigating information processing and the self in borderline personality disorder. Currently, she is the Director of Clinical Research for the Laboratory of Adolescent Sciences at Vassar College. Dr. Veague lives in Stockbridge, Massachusetts, with her husband and children.

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