Psychosocial rehabilitation in psychosis — structured clinical viva

Why not working if voices better? Explain clinical versus functional recovery: cognition, negatives, skills, confidence, stigma and opportunity barriers continue after positive-symptom improvement. Medication is necessary but not sufficient.^[1][5]

Keep him home until 100% cured? Prolonged enforced inactivity worsens secondary disability. Early multi-element care including vocational/education pathways improves outcomes (RAISE-type packages; Killackey IPS in FEP). Temporary adjustments yes; automatic abandonment of roles no.^[3][4]

IPS. Place-then-train supported employment: competitive jobs, rapid placement, zero exclusion based on readiness tests, integrated employment specialist, preferences, ongoing support. Meta-analysis supports roughly doubled competitive employment odds versus traditional vocational approaches.^[2][4]

Family meetings. Structured family psychoeducation (not blame sessions): education, communication, problem-solving, reducing high EE — relapse prevention evidence.^[7][8]

Is recovery early discharge? Name Slade uses and abuses. Genuine recovery-oriented care partners on goals (CHIME) while continuing evidence-based treatment and risk management. Recovery rhetoric must never justify under-treatment.^[5][6]

Package to name. Optimised medication + family PE + IPS/supported education + cognitive remediation if needed + illness management + intensity matching engagement risk. PORT scaffolding for examiners.^[1][8]