TY - JOUR T1 - Psychosocial treatments for schizophrenia: insights from Russian theoretical psychology JF - General Psychiatry JO - Gen Psych DO - 10.1136/gpsych-2020-100234 VL - 33 IS - 5 SP - e100234 AU - Natalia Semenova Y1 - 2020/10/01 UR - http://gpsych.bmj.com/content/33/5/e100234.abstract N2 - While the biological approach remained at the forefront in Russian/Soviet psychiatry, several valuable theoretical approaches were developed in Russian/Soviet psychology. This development, however, did not cross the border of the psychiatric domain. The clinical implications of these psychological constructs for the psychosocial treatment of severe mental illness (SMI) were overlooked.In this article, I shall focus on psychosocial treatments for schizophrenia and explore how the corresponding data aligns with theoretical concepts developed by Lev Vygotsky and Aleksei Leontiev. In addition, I shall briefly describe the theoretical underpinnings of general Russian/Soviet approaches to the treatment of the mentally ill.During most of the Soviet era, the biological approach strongly dominated Russian psychiatry. Psychological approaches to the treatment of the mentally ill were primarily based on the ideas of Pavlov and Marx. The treatment was mostly of the directive type (ie, discrete symptoms or problems were addressed in a highly structured, systematic and narrowly focused way). Group psychotherapy was developed on the basis of the principles of Soviet pedagogical science, in particular, of the Soviet educationalist Makarenko1 and reflected the dominant collectivist idea of a person being a function of the collective.The situation changed during the last few decades under the increased influence of Western thought. In line with the results of recent meta-analyses demonstrating evidence for the effects of psychosocial treatments in schizophrenia,2–5 the overall approach has become balanced, and one can no longer insist on neuroleptic therapy alone.In parallel development, a conceptual change occurred in the organisation of Russian psychiatry, which resulted in a departure from the hospital-centred approach towards deinstitutionalisation and a community-oriented model of care.6 From this point of view, the psychiatric hospital becomes a link in a ‘rehabilitation chain’ reaching far into the community. Psychosocial treatments and interventions play an essential role … ER -