Models of Change in Schizophrenia: One for All, or All for Some?

Approaches to the study and treatment of schizophrenia can be classified according to their views of ‘recovery’, for example what it means and how likely it is to occur, often crudely distinguished as the ‘medical’ or ‘empowerment‘ models. A further source of difference relates to whether recovery is seen as primarily intrapersonal or interpersonal. We suggest that combining these dimensions provides a useful two-dimensional space in which to map out such approaches. This is illustrated in the first section of this paper using several models of change in schizophrenia. In the second section, we review empirical data pertaining to the meaning of recovery and how this relates to models of change. We conclude that no one model of change or definition of recovery should hold sway, but that instead each may have value according to the conditions that are most limiting for a particular individual - whether symptoms, social disadvantages, or other factors. Moreover, as these conditions change, so may the model of change or definition of recovery that it is most useful to use.