Dispelling Misconceptions and Building Therapeutic Alliances in Schizophrenia Treatment

Psych Congress NP Institute Steering Committee Member Amber Hoberg, MSN, APRN, PMHNP-BC, of Morningstar Family Medicine, addresses the common misconceptions around patients with schizophrenia that can hinder treatment success. Learn why listening to patients' perspectives and establishing a therapeutic alliance is essential for providing effective care.

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Read the transcript:

Hi, I’m Amber Hoberg. I'm a psychiatric mental health nurse practitioner in San Antonio, Texas with Morningstar Family Medicine, and I'm also a section editor for Psych Congress Network. 
There are lots of misconceptions about patients with schizophrenia. Sometimes I hear, “well, they just don't like to take their medications,” or “they just don't want to get better.”

That's not true. 

In my personal practice, my patients do want to get better and they do want to take medications, but they want to be heard. That's the one thing I find more than anything. It's making sure that you sit down. 

First of all, before you even start talking to them about their disease state or medications, get to know them as a person. Try to find like common interest. What are things that they're interested in, maybe that you're interested in and something where you can find a common ground to build that rapport and that therapeutic alliance. Most important is having that [rapport] with your patients.

Secondly, you are the guide. You're not the dictator. You're the guide.

Your job is to pull out of your patients what is important to them. Your job is to pull out maybe what has happened on previous medications that have made them noncompliant. Then use yourself as an ability to provide them resources, to provide them options, and then make them active participants in their care by letting them make the choice.

Because when a patient chooses and when you make them part of the treatment decisions, the chances of them becoming noncompliant are much less.

So, there are a lot of misconceptions out there, but these patients do want to get better, they do want to improve, and they do want to take medications that will work for them. 

It's just we need to be more patient, and we need to listen more closely.

Amber Hoberg, MSN, APRN, PMHNP-BC, is a board-certified psychiatric mental health nurse practitioner from University of Texas Health Science Center San Antonio. She has been working for the past 12 years with the adult and geriatric populations, treating all types of psychiatric conditions. Her background, as a Psychiatric Advanced Practice Nurse, includes outpatient, inpatient, group home, and nursing home/ALF settings. She currently works for Baptist Health System and Morning Star Family Medicine PLLC treating the chronically mentally ill in both inpatient and outpatient settings.