Soteria (psychiatric treatment)

Soteria is a psychiatric treatment approach designed for individuals diagnosed with schizophrenia and other psychotic disorders. It emphasizes a psychosocial model for treatment, focusing on creating a supportive and therapeutic environment, rather than relying primarily on pharmacotherapy and conventional hospitalization. The Soteria model is based on the principles of interpersonal communications, understanding, and respect for the individual's experience of psychosis.

History

The Soteria project was initiated in the early 1970s by psychiatrist Loren Mosher, who sought to demonstrate that individuals experiencing a psychotic episode could be treated successfully in a community setting without the extensive use of antipsychotic medications. The first Soteria house opened in San Jose, California, in 1971, providing a residential environment that was markedly different from the traditional psychiatric ward. The approach was named "Soteria" after the Greek word for "salvation" or "deliverance," reflecting the project's goal of helping individuals find a path to recovery that did not solely rely on medication.

Philosophy and Approach

The core philosophy of Soteria is grounded in the belief that psychosis can be a temporary state resulting from stressful life events or trauma, and that recovery is possible in a supportive and understanding environment. The approach emphasizes the importance of human relationships and communication, and it seeks to minimize the use of antipsychotic drugs, especially during the initial treatment phase.

Soteria houses are typically small, home-like settings where residents live together with a small staff, who often do not wear uniforms or assume traditional clinical roles. The treatment focuses on creating a nonjudgmental, safe, and supportive environment where individuals can explore their thoughts and feelings without fear of coercion or forced medication.

Key Components

• Nonmedical Setting: Soteria houses are designed to be as unlike a hospital as possible, offering a homelike atmosphere that fosters a sense of normalcy and belonging.
• Community: Residents are encouraged to support each other and participate in the daily activities of the house, fostering a sense of community and shared experience.
• Minimal Use of Medication: While not opposed to the use of medication altogether, the Soteria model prioritizes psychosocial interventions and uses antipsychotic drugs more sparingly and at lower doses than traditional psychiatric treatments.
• Individualized Care: Treatment is tailored to the individual's needs, with a focus on understanding the person's unique experience of psychosis and providing support that respects their autonomy and dignity.

Effectiveness

Research on the Soteria model has shown promising results, with several studies indicating that individuals treated in Soteria-like environments have similar, if not better, outcomes compared to those receiving conventional hospital treatment, especially in terms of lower medication use and improved social functioning. Critics, however, argue that more extensive and rigorous studies are needed to fully understand the effectiveness and applicability of the Soteria approach.

Current Status

While the original Soteria houses have closed, the principles of the Soteria model have influenced the development of similar programs worldwide. These programs continue to explore and apply the concepts of minimal medication use and psychosocial support in the treatment of psychosis.

See Also

• Psychosis
• Schizophrenia
• Psychosocial
• Loren Mosher