ABSTRACT
This chapter provides a succinct overview of treatment approaches to the main psychosocial issues confronted by psychiatric clinicians in dealing with psychotic symptoms and chronic psychosis in daily practice. The main premises of this chapter are summarized in the following propositions:
There is limited evidence-based information to guide clinicians in the choice, intensity, or length of psychosocial interventions for children and adolescents suffering from psychotic spectrum disorders.
To a large extent, interventions in children and adolescents are based on psychotherapeutic and psychiatric experience with adult patients, with sensitive attention to developmental and family interaction issues.
Psychosocial interventions are important components of the comprehensive treatment plan of psychotic disorders.
Research has consistently demonstrated that combined psychopharma-cological and psychosocial treatments improve the therapeutic effect size, and that in general, pharmacological interventions have effect size superiority over psychosocial interventions when their therapeutic impact is compared.
The psychotic child needs a variety of integrated psychosocial, educational, and vocational interventions.
The psychotic child benefits from applied individual psychotherapeutic techniques aimed at improving subjective states and functioning skills.
Family interventions aid family members to understand the child's issues, improve parental consistency in the provision of effective discipline, and assist parents in the prevention of regressive behaviors in psychotic children.
Parents are a key factor in achieving medication compliance and adherence to other components of the treatment plan.
At all times, psychiatrists will monitor substance abuse, suicide and homicide risks, as well as the risk for endangerment of the living or cultural environment.
The risk of terrorism and of school massacres is becoming an unfortunate reality that neither the schools nor mental health professionals can ignore. Psychiatrists need to be on the alert for the identification and timely intervention of these possibilities.
