LEAP method and schizophrenia

Several Blog posts ago, we talked about Anosognosia. Today, we’ll talk about the LEAP method and schizophrenia, a mainstream, proven approach to helping people overcome anosognosia and accept treatment for their mental illness or brain disorder. I will reproduce here an edited extract from the transcript of Chapter 6 of my podcast “Schizophrenia as I Live It.” That chapter was entitled “Anosognosia and the LEAP method.” Recall from our recent Blog post that anosognosia is from the Greek “to not know a disease.”

  •  NAMI (National Alliance On Mental Illness) defines it on their website https://nami.org, as follows:

“When we talk about anosognosia in mental illness, we mean that someone is unaware of their mental health condition or can’t perceive their condition accurately. Anosognosia is a common symptom of certain mental illnesses, perhaps the most difficult to understand for those who have never experienced it.”

  •  The Schizophrenia and Psychosis Action Alliance defines it on their website https://sczaction.org/, as follows:

“Anosognosia is a neurological symptom that prevents people living with schizophrenia and related brain diseases from understanding they have the disease. An estimated 57% to 98% of people living with schizophrenia experience anosognosia, which is the most common barrier to seeking what can be lifesaving medical care. Anosognosia often causes a person with schizophrenia to refuse treatment, leading to severe negative health outcomes – including reducing a person’s life expectancy by an average of 28.5 years. Anosognosia also increases the risk of homelessness and arrest. “Anosognosia is a cruel condition that stands in the way of effectively treating schizophrenia and psychosis disorders,” says Dr. Xavier Amador, CEO of the Henry Amador Center on Anosognosia. “The more we understand it, the more successful we will be in overcoming its impact and getting people the treatment they need and deserve.”

  •  What is LEAP?

LEAP stands for Listen Empathize Agree Partner and is a method founded and developed by Dr Xavier Amador, the doctor we mentioned in the last quote, designed to empower you to help someone you know accept treatment for their mental illness. It is now a mainstream method that has given rise to many people trained in its practice, and it is widely successful in helping those with anosognosia accept treatment.

  •  LEAP stands for:

L=Listen

E=Empathize

A=Agree

P=Partner

  •  Dr. Xavier Amador has written an important, groundbreaking book about anosognosia and LEAP. It is now in its 20th-anniversary edition, entitled: “I am not sick; I don’t need help! How to help someone accept treatment – 20th-anniversary edition.” It’s available from amazon.com and as an audiobook on the Audible app. 
  •  This book is not the only valuable one written by Dr. Xavier Amador, but it is the best place to start if you want to learn more about the approach to handling anosognosia via LEAP.
  •  Recent exciting news: The Schizophrenia & Psychosis Action Alliance (S&PAA) has formed a strategic collaboration with the Henry Amador Center on Anosognosia and the LEAP Institute to create The Anosognosia Coalition, whose goals are to raise insights into and awareness of the dangerous condition of anosognosia and develop policies to reduce its negative impact on people living with schizophrenia and psychosis disorders.
  •  Like the Henry Amador Center on Anosognosia, the LEAP Institute is an outgrowth of the method of Dr. Xavier Amador.
  •  Let’s say a little more about the words LEAP stands for. I use as a reference an Australian website run by Carers Queensland Carer Advisory Service; see the MHR4C website https://mhr4c.com.au/coping-strategies/the-leap-approach/

L=Listen: “Listen with only one goal: to understand the other person’s point of view and reflect your understanding back to them.”

Effective listening involves sitting back and listening to the frustrations, fears, hopes, and dreams of the person you care for and repeating back your understanding of what has been said. You can use effective listening to stop yourself from offering your opinion or advice.

E=Empathize: “If you want someone to seriously consider your point of view, be certain they feel you have seriously considered theirs.” 

Empathizing with another is identifying their feelings, thoughts, and attitudes. To convey your empathy to the person you care for, you can acknowledge the following:

  •  that their delusional beliefs may be frightening
  •  their desire to prove they are not sick
  •  their wish to avoid treatment

A=Agree: “When facing someone who rigidly holds irrational beliefs, you gain nothing by disagreeing.”

It is essential to reach an agreement. To do this:

  •  discuss only problems or symptoms perceived by the person you care for
  •  review the advantages and disadvantages of treatment
  •  reflect back and highlight the perceived benefits
  •  if need be, agree to disagree on some things

P=Partner: “When you share the same goals, you can work together instead of being at odds.”

You can partner by moving towards goals you agree can be worked on together. You can also partner by agreeing on goals that challenge the person you care for to step outside their comfort zone but are still within their ability to achieve.

If you want to know more about anosognosia and LEAP, I strongly urge you to read or listen to the book recommended above by Dr. Xavier Amador, namely “I am not sick, I don’t need help. How to help someone accept treatment.”

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