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In 2004, the American Psychiatric Association (APA) published recommended practice guidelines for the treatment of schizophrenia, some of which are included here.

During the acute psychotic phase, the goals of treatment include:

• Preventing the patient from inflicting harm to themselves or to others
• Controlling disturbing behavior
• Reducing the severity of symptoms of psychosis
• Identifying the trigger of the episode, if possible
• Developing a therapeutic alliance with the family

A thorough physical and psychiatric examination is performed with an evaluation of substance abuse and a toxicology screening. Special attention should be paid to suicide ideation or any indicators of aggressive behavior or violence. Medication with an antipsychotic should be started immediately. Patients who are suffering a relapse episode due to noncompliance with previous medication protocols should be considered for long-acting injectable antipsychotic therapy.

Comorbid conditions may require additional (adjunctive) medication, including:

• Benzodiazepines for anxiety and agitation
• Antidepressants for depression or obsessive-compulsive disorder
• Mood stabilizers or beta blockers to reduce the severity of hostility and aggression

Psychosocial intervention may be initiated with the goal of reducing overstimulation; improving or calming stressful relationships or life events; and promoting relaxation.

Goals during the stabilization phase (psychotic phase which as been brought under control) include:

• Reducing stress
• Minimizing risk of relapse through support to the patient and family
• Reducing residual symptoms
• Promoting recovery
• Easing the patient's reintegration into community living

If the medication given to the patient during the acute phase was effective, the APA strongly recommends continuing the medication for at least six months before evaluating the next step in medical therapy. Side effects of medication should be carefully monitored. The patient is particularly vulnerable to relapse during this time and needs ongoing support in re-entering normal life and communal activities.

Upon entering the stable phase of schizophrenia, the goals of treatment become:

• Sustaining symptom remission or control
• Ensuring that the patient is making progress in improving functioning and quality of life
• Initiating proper treatment for residual symptoms or any signs of relapse
• Continuing monitoring for adverse reactions to the medication

Left untreated, patients with schizophrenia are at very high risk for relapse of psychotic episodes. Antipsychotic medication is strongly recommended by the APA during the stable phase since they have proven themselves to be effective in reducing the risk of relapse. Antipsychotic medications also often improve positive symptoms and, for some patients, may even help them go into remission. Even so, negative symptoms continue causing difficulties such as overall functional impairment (e.g. social, cognitive, and vocational).

Psychosocial treatment recommended by the APA during the stable phase of schizophrenia includes:

• Family intervention to educate the family regarding how to provide support for the patient, train the family in problem solving for issues that arise, improve communication with the patient and with professionals, and how to recognize signs of relapse
• Cognitive-behavioral therapy to address impaired social skills and function as well as to reduce symptom severity, and improve negative symptoms and quality of life
• Supported employment to improve vocational training, reintegration in to the employment sphere, and to provide a venue and opportunity for the patient to learn skills associated with employment, such as communication with customers, peers, and supervisors.