CLINICAL HANDBOOK OF SCHIZOPHRENIA

27. Illness Self-Management Training 277tings, peer support centers, day treatment and residential faiclities, and on assertive communitytreatment teams. Each person with schizophrenia should have the opportunity tolearn about his or her illness and to take an active role in treatment and in recovery.Therefore, mental health facilities providing services for people with schizophreniashould offer an illness self-management program as a routine component of their basicservices.KEY POINTS• People with schizophrenia are capable of learning how to manage their illness in collaborationwith professionals and significant others.• Motivation to learn illness self-management strategies can be harnessed by helping clientsestablish personal goals, then exploring with them how improved illness management canhelp them achieve their goals.• The stress–vulnerability model of schizophrenia provides a general framework for improvedillness self-management and includes fostering medication adherence, reducing substanceabuse, reducing stress, increasing social support, and improving coping with stress andsymptoms.• Psychoeducation about the nature of schizophrenia and the principles of its management iscritical to informing clients about their choices and involving them in shared decision makingabout their treatment.• Insight into having schizophrenia is not a prerequisite to learning illness self-managementskills, nor is acceptance of the diagnosis necessary.• Empirical research supports several practices for improving illness self-management, includingbehavioral tailoring for medication adherence (fitting medication into the client’sdaily routine), relapse prevention training, social skills training to improve social support,and coping skills training to handle stress and persistent symptoms.• A variety of standardized illness self-management programs have been developed, eachwith unique but overlapping components with other programs.• Peer support programs provide alternatives to traditional mental health services for opportunitiesto learn illness self-management strategies from other individuals with mental illness.REFERENCES AND RECOMMENDED READINGSBellack, A. S., Mueser, K. T., Gingerich, S., & Agresta, J. (2004). Social skills training for schizophrenia:A step-by-step guide (2nd ed.). New York: Guilford Press.Copeland, M. E. (1997). Wellness Recovery Action Plan. Brattleboro, VT: Peach Press.Copeland, M. E., & Mead, S. (2004). Wellness Recovery Action Plan and peer support: Personal,group and program development. Dummerston, VT: Peach Press.Gingerich, S., & Mueser, K. T. (2002). Illness management and recovery. Concord, NH: West Institute.Also available online at www.samhsa.govGingerich, S., & Mueser, K. T. (2005a). Coping skills group: A session-by-session guide. Plainview,NY: Wellness Reproductions.Gingerich, S., & Mueser, K. T. (2005b). Illness management and recovery. In R. E. Drake, M. R.Merrens, & D. W. Lynde (Eds.), Evidence-based mental health practice: A textbook (pp. 395–424). New York: Norton.Hasson-Ohayon, I., Roe, D., & Kravetz, S. (2007). A randomized controlled trial of the effectivenessof the illness management and recovery program. Psychiatric Services, 58, 1461–1466.Hogarty, G. E. (2002). Personal therapy for schizophrenia and related disorders: A guide to individualizedtreatment. New York: Guilford Press.Liberman, R. P., Wallace, C. J., Blackwell, G., Eckman, T. A., Vacccaro, J. V., & Kuehnel, T. G. (1993).