Residential Treatment of Schizophrenia at CooperRiis: An Empowering Approach
Schizophrenia, schizoaffective disorder, and other psychotic spectrum disorders treatment at CooperRiis happens in an open and peaceful residential setting that allows individuals to progress through a continuum of care that starts at one of our main campuses in Asheville or Mill Spring, and extends into a network of community-based homes in either Asheville or Tryon. This allows for the option of both short- and long-term residential treatment.
Our recovery model aims to help residents construct lives of meaning and purpose. Since residents are at the center of everything we do, residents are always in charge of their recovery. When working with our residents, we meet with ‘Jim,’ instead of talking about how to fix ‘Jim.’ This is a very important distinction for both the resident, and the people working with him.
At present, schizophrenia does not have a cure so we must help those diagnosed with this illness to attain maximum recovery. When people enter our care, it is important we get to know them and collaboratively develop a personalized recovery plan.
Medications and Supplements
When someone first enters our program, we look to see if their symptoms have an organic source, such as gluten intolerance, Lyme disease, or traumatic brain injury, and then try to treat that source. If there isn’t an organic contributor, we seek to find the correct medication strategy.
The resident has an initial meeting with our Integrative Psychiatry Director to go over the resident’s medical history as well as how he or she is feeling at the moment. Residents undergo a full psychiatric evaluation, including a history of their lives, symptoms, and illness. They also tell us what has and has not been helpful in treating their schizophrenia. The Integrative Psychiatry Director and the resident discuss goals for medication, and then the resident decides what approach is most comfortable. This shared decision-making approach has been very successful for our residents and they feel empowered in their own recovery.
At CooperRiis, we strive for the lowest dose of medication for the highest effect.
At CooperRiis, we strive for the lowest dose of medication for the highest effect. Residents are fully involved in this process by keeping us apprised of how they are feeling and if their symptoms have subsided. Symptom reduction is a goal of medication, but it is not our only goal. If a resident takes medication and all their symptoms go away but they are constantly nauseous or cannot get out of bed, it is not a sustainable solution. Quality of life should improve with symptom reduction. Our goal is for medication to work long-term, with the fewest symptoms and side effects possible.
We also use supplements like vitamins, minerals, fish oil and herbal extracts to improve well-being and improve recovery outcomes.
A Focus on Wellness and Possibility
At CooperRiis, we operate from a recovery model. Instead of focusing on illness and diagnosis, we shift the focus to wellness and possibility. We believe that recovery is possible for everyone but it is a very personal process. We try to empower residents to find their highest level of functioning and fulfillment.
The Dream Statement
When residents join CooperRiis, one of the first things we do is have them articulate their largest hopes and dreams for their lives. We call this the Dream Statement. The Dream Statement helps empower residents to take charge of their recovery.
People with schizophrenia who enter our program are often in crisis and have lost focus and direction. The Dream Statement becomes a road map for their recovery.
The Dream Statement helps the resident set goals; core goals that are achievable in three months and goals that are achievable over one to two week periods. The Dream Statement can be as lofty as the resident wishes. The smaller weekly and monthly goals are always aimed toward the larger dream, giving the resident both a short-term and longer-term horizon.
For example, if a resident wants to attend and graduate from college (Dream Statement) then a weekly goal may be to get out of bed every day. As a step toward dream fulfillment, one must get out of bed to attend class. Instead of viewing getting out of bed in a negative light, the resident may begin to see getting out of bed as a first step toward college. We always strive to relate the daily and weekly goals to the Dream Statement so that residents are working toward something that is important to them.
What is Schizophrenia?
Schizophrenia is a chronic mental disorder that affects how a person thinks, feels, and behaves. The causes and symptoms can vary among individuals. Schizophrenia affects about one percent of the population, appearing in both men and women equally, though symptoms tend to begin earlier in men. The disorder is present in all ethnic groups. In extremely rare cases, children under the age of 16 have been diagnosed with schizophrenia.
Phases of Schizophrenia
The phases of schizophrenia are prodromal, active, and residual. At CooperRiis, we include ‘recovery’ on this list because we believe recovery is possible.
People with schizophrenia are often misdiagnosed in the prodromal phase because of the wide array of symptoms that can be present and their subtlety. Symptoms in the prodromal phase include:
- Withdrawal from family and social life
- A preference for being alone
- Outbursts of anger
- Loss of interest in normal activities and apathy
- Odd behavior
Over time, symptoms worsen and the active phase of schizophrenia begins. Symptoms in this phase will be obvious to family and friends and include:
- Paranoid delusions
- Disorganized speech
- Disorganized behavior
- Confusing thought patterns
- Trouble concentrating
Symptoms in the residual phase resemble those in the prodromal stage. While alarming symptoms of the active stage have mostly subsided, symptoms such as low energy, listlessness, and withdrawal can still be present.
With treatment, most people with schizophrenia will improve with time. Most of our residents come to us in the active or residual phases of schizophrenia, but regardless of where they are, our goal is always the same – to help residents move into the recovery phase by achieving the highest level of fulfillment and functioning possible.
About the Author
Michael Groat, PhD, MS is President and CEO of CooperRiis residential treatment program located in Asheville and Mill Spring, North Carolina. Michael earned his Ph.D. in Counseling Psychology from SUNY-Albany. Prior to joining CooperRiis, he was associate professor of psychiatry and behavioral sciences at the Baylor College of Medicine, Houston, TX, where he also served as director of the division of adult services at the Menninger Clinic.
Michael is also a former candidate in adult psychoanalysis at the Center for Psychoanalytic Studies, Houston, and completed a 4-year fellowship in psychodynamic psychotherapy at the Austen Riggs Center. He has published on suicide prevention, applications of attachment research, and uses of clinical outcomes, and has lectured nationally and internationally on the same. Michael has long-standing interest in suicide prevention, therapeutic communities, organizational and systemic interventions, personality assessment, and intensive psychotherapy.