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Schizophrenia: Practical Strategies for Relapses & Reducing Symptoms
10 CEUs Schizophrenia: Practical Strategies for Relapses & Reducing Symptoms

Section 10
Conflict Resolution with Schizophrenia

Question 10 | Test | Table of Contents | Schizophrenia CEU Courses
Social Worker CEU, Psychologist CE, Counselor CEU, & MFT CEU

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On the last track we discussed skills for communicating effectively.  The six skills for communicating effectively are getting to the point, directly expressing feelings, giving positive feedback, making positiv requests, checking out feelings, and taking breaks.  

On this track we will discuss five strategies for managing conflict.  As you know, managing and resolving conflict may require the same communication skills described on the last track.  However, regarding conflict, I have found that five additional strategies can be productive.  These five strategies for managing conflict are avoiding blame, speaking calmly, being concise, discovering points of view, and focusing on the present.

5 Strategies for Managing Conflicts

Strategy #1 - Avoiding Blame
First, let’s examine avoiding blame.  Terrell was caring for his older brother Ron, age 36, who had schizophrenia.  Ron had asked Terrell for several loans throughout the year and had failed to pay any of the money back.  Terrell knew that he should avoid blaming Ron, but needed to resolve the conflict. 

I stated to Terrell, "Rather than blaming Ron for not paying back his loans, describe the problem, explain how you feel, and focus on finding solutions.  For example, you could say, "I feel frustrated because I run short of money at the end of the month.  I’d like to talk about this and see what we can do to solve this problem."  Would you agree that by focusing on solutions instead of placing blame, Terrell made it possible to have a more constructive dialogue with his brother?"

Strategy #2 - Speaking Calmly
Terrell also focused on speaking calmly.  Terrell stated, "I think Ron is much more receptive when I use a calm voice than when I try to be forceful. I remember hearing that people with schizophrenia are sensitive to harsh sounds, so I try to avoid shouting or using a negative tone of voice."  Consider your client. What negative symptoms of schizophrenia can be minimized by speaking calmly?

Strategy #3 - Being Concise
In addition to avoiding blame and speaking calmly, the third strategy for managing conflict is being concise.  Clearly, as with getting to the point on the last track, being concise can be vital to keeping a conversation with a schizophrenic client on track.  Vanessa’s father Fred found it helpful to keep in mind that short, clear, and specific statements are easier to understand and respond to than lengthy statements. 

For example, Fred, age 50, became concerned that his daughter, Vanessa, age 24, would lose her subsidized housing because of the fire hazard of numerous piles of newspapers and magazines. When Fred talked to Vanessa about the problem he digressed. Fred stated to me, "I got off track. I started in about how she used to keep old papers and magazines when she was a teenager. Then I started in about her housekeeping habits in general. Vanessa has this dirty old stained chair and that reminded me of some new upholstered chairs a guy at work was giving away, so I started telling her about that. I don’t think she got the point of her piles of newspapers being a fire hazard at all, because she apparently didn’t know how to respond."

As you can infer, had Fred avoided talking about things that were unrelated, Vanessa may have understood his point. Could pausing frequently to review what has already been said also help your schizophrenic client stay on track?

Strategy #4 - Discovering Points of View 
Next, let’s examine ways of discovering points of view.  Before Fred tried to talk to Vanessa about the fire hazard in her apartment again, I reviewed ways he could avoid a one sided conversation.  I stated, "Even if you are concise and stay on track, Vanessa may have trouble expressing herself. 

Five Ways to Actively Ask for an Opinion

  • "I’m interested in your perspective."
  • "How would you describe this situation from your point of view?"
  • "What do you think?"
  • "What’s your opinion?" or
  • "What do you think might be some possible solutions?"

Fred was sure to allow Vanessa enough time to consider her point of view and answer him.  Do you agree that if a family member of a client with schizophrenia fails to seek the client’s opinion, then the client may feel frustrated and less interested in resolving the conflict?

Strategy #5 - Focusing on the Present
In addition to avoiding blame, speaking calmly, being concise, and discovering points of view, the fifth strategy for managing conflict that we will discuss is focusing on the present.  Because personalities can be difficult to change, I encourage the family members of clients with schizophrenia to focus on changing behavior by focusing on the present and on specific behaviors.  As we have already discussed, clients with schizophrenia can be discouraged by criticism. 

For example, comments about being lazy or irresponsible can be upsetting and distract a client with schizophrenia from attending to the problem at hand.  Gerald, age 42, was married to Cynthia, age 39.  Cynthia was diagnosed with schizophrenia.  Cynthia took medication to regulate her symptoms as well as her mood, but the medication did not decrease her impulsivity regarding spending money.  Therefore, Gerald found it more productive to concentrate on how they could follow a budget for the coming month and avoid referring to past financial problems or describing Cynthia as extravagant. 

Think of your Cynthia.  Could focusing on the present help your client’s family member manage or resolve a specific conflict?

On this track we have discussed five strategies for managing conflict.  These five strategies for managing conflict are avoiding blame, speaking calmly, being concise, discovering points of view, and focusing on the present.

On the next track we will discuss  anger in schizophrenia.  Our discussion will be include three main topics.  These three topics are anger related to delusions, strategies for coping with anger, and problem solving strategies for clients with schizophrenia.

Peer-Reviewed Journal Article References:
McNeely, H. E., West, R., Christensen, B. K., & Alain, C. (2003). Neurophysiological Evidence for Disturbances of Conflict Processing in Patients With Schizophrenia. Journal of Abnormal Psychology, 112(4), 679–688.
Mulligan, L. D., Haddock, G., Emsley, R., Neil, S. T., & Kyle, S. D. (2016). High resolution examination of the role of sleep disturbance in predicting functioning and psychotic symptoms in schizophrenia: A novel experience sampling study. Journal of Abnormal Psychology, 125(6), 788–797. 

Smid, H. G. O. M., Bruggeman, R., & Martens, S. (2016). Normal cognitive conflict resolution in psychosis patients with and without schizophrenia. Journal of Abnormal Psychology, 125(1), 88–103. 

What are five strategies for managing conflict? To select and enter your answer go to Test.

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