The Effects of Solution-Focused Approach on Psychosocial Adjustment and Treatment Adherence in Individuals Diagnosed With Schizophrenia: A Randomized Controlled Trial

Abstract

Background: Schizophrenia is a chronic psychiatric disorder characterized by persistent impairments in psychosocial functioning and treatment adherence. Community-based mental health services require nursing interventions that support recovery-oriented, person-centered care.Aim: This study aimed to examine the effects of a solution-focused approach (SFA) on psychosocial adjustment and treatment adherence in individuals diagnosed with schizophrenia.Method: This randomized controlled pretest-posttest study, conducted at a community mental health center in T & uuml;rkiye, assigned participants to an experimental (initial n = 30; completers n = 27; mean age = 48.4 +/- 13.47; 66.7% male) or a control group (initial n = 30; completers n = 26; mean age = 55.0 +/- 7.03; 87.6% male) via gender-stratified, computer-assisted randomization. The experimental group received six weeks of individual, face-to-face solution-focused sessions led by a psychiatric nurse, while the control group continued routine care. Psychosocial adjustment and treatment adherence were assessed pre- and post-intervention using the Psychosocial Adjustment to Illness Scale-Self Report (PAIS-SR) and the Morisky-Green-Levine Adherence Scale (MGL).Results: Groups were similar at baseline. Post-intervention, the experimental group showed a significant reduction in PAIS-SR scores, indicating improved psychosocial adjustment, with notable gains in occupational functioning, family environment, social relationships, and psychological distress. No significant change occurred in the control group. Delta and mixed ANOVA analyses confirmed significantly greater improvement in psychosocial adjustment for the experimental group (p < .001). Treatment adherence also increased significantly in the experimental group, with a statistically significant between-group difference (p = .002).Conclusion: A 6-week, nurse-led solution-focused intervention significantly enhanced psychosocial adjustment and treatment adherence in individuals with schizophrenia. This approach can substantially contribute to recovery-oriented, person-centered psychiatric nursing practices in community-based mental health services.