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The Johns Hopkins Five-Step Approach to Clinical Care

The Schizophrenia Center

We emphasize a systematic, comprehensive approach to the diagnosis and treatment of schizophrenia and related disorders. In our view, each patient is a unique individual, with his or her own strengths and vulnerabilities. We recognize the critical role of family and friends in the life of each patient, and the potential contribution of personality traits, medical illnesses, and social network to the manifestation and treatment of the symptoms of schizophrenia and related disorders.

Step 1.  Diagnosis:  Is schizophrenia the correct diagnosis? What additional clinical information or laboratory tests are necessary to clarify the diagnosis?

Step 2.  Individualized assessment:  What are the unique strengths and vulnerabilities of each patient? What are the immediate and long-term goals of each patient, and the hopes and expectations of their family and friends? 

Step 3.  Treatment plan development:  What types of support, treatment, services, and resources will be necessary to help each patient reach their goals? Does the patient need medicine, and if so, which one and at what dose?   

Step 4.  Treatment plan implementation.  What are the responsibilities of the patient, the family, and the clinicians? What part of the plan needs to be implemented immediately, and what can be added more slowly? 

Step 5.  Reassessment and update of treatment plan. Are the goals being achieved? Do changes in symptoms, new life events, or a lack of response to treatment require a change in the plan?   


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