Enhancing systematic implementation of skills training modules for persons with schizophrenia: Three steps forward and two steps back? (original) (raw)
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Psychosocial Skills Training for Schizophrenia: Lessons From the Laboratory
Schizophrenia Bulletin, 2000
A large body of research supports the efficacy of psychosocial treatments for schizophrenia, particularly learning-based therapies. The Schizophrenia Patient Outcomes Research Team recommended that cognitive-behavioral therapies be used in schizophrenia, and skills training was included in the practice guideline for treating patients with schizophrenia published by the American Psychiatric Association. This article provides an updated review of empirical studies of psychosocial skills training, showing its value in treating patients with schizophrenia as well as its broader clinical effectiveness. Data supporting the efficacy of psychosocial skills training continue to accumulate. Such programs should continue to be included in best practices guidelines and treatment recommendations for schizophrenia. Future clinical service research could be directed toward integration of skills training with other psychosocial treatment methods. http://schizophreniabulletin.oxfordjournals.org/ Downloaded from 2. Social skills training has a positive effect on patients'
Psychosocial rehabilitation journal, 1990
These findings suggest that the Medication Management Module can be used effectively by mental health practitioners representing a diversity of disciplines. Based on this evaluation of the Medication Management Module, further module development in other areas of independent living promises a useful technology for teaching people with schizophrenia skills that are widely relevant to community adaptation.
Psychological interventions for schizophrenia : Schizophrenia : treatment outcomes research
Schizophrenia Bulletin, 1995
This review examines the impact of dynamic and supportive psychotherapies (both individual and group) and psychosocial skills training on clinical and social outcomes for individuals with schizophrenia. The relatively few controlled trials of individual or group psychotherapies for persons with schizophrenia exhibit serious methodological problems that limit their generalizability. Reality-oriented approaches appear to be superior to dynamic, insight-oriented psychotherapies, but further research is needed to identify and evaluate disorderspecific models that target specific deficits and disabilities in schizophrenia. Research on psychosocial skills training models shows that target skills can be trained and maintained over time. Further work is needed to determine the extent to which trained skills generalize from the original training setting to "real life" environments.
American Journal of Psychiatry, 2002
Objective: Although skills training is a validated psychosocial treatment for schizophrenia, generalization of the skills to everyday life has not been optimal. This study evaluated a behaviorally oriented method of augmenting clinic-based skills training in the community with the aim of improving opportunities, encouragement, and reinforcement for outpatients to use their skills in their natural environment. Method: Sixty-three individuals with schizophrenia were randomly assigned to 60 weeks of clinic-based skills training alone or of clinic-based skills training supplemented with manual-based generalization sessions in the community. Patients were also randomly assigned to receive either haloperidol or risperidone. Therapists' fidelity to the manuals was measured. Patients' acquisition of the skills from pre-to posttraining was evaluated. The primary outcome measures were the Social Adjustment Scale-II and the Quality of Life Scale.
In-Home Psychosocial Skills Training for Patients With Schizophrenia
Psychiatric Services, 2006
Objective: The purpose of this study was to test an intervention that adapted the University of California, Los Angeles (UCLA) social and independent living skills program for application in the patient's home and in an outpatient setting in Spain. Methods: An intervention group of 32 patients with schizophrenia was selected for comparison with a matched control group of patients who were undergoing conventional outpatient treatment for schizophrenia during six-month treatment periods. The Positive and Negative Syndrome Scale (PANSS) scoring system was used to compare the two groups, with a pretest-posttest design. Results:
Generalization of cognitive training in an Australian sample of schizophrenia patients
Comprehensive Psychiatry, 2013
Objective: The present study was undertaken to evaluate the effect of cognitive training in improving trained and untrained cognitive processes in schizophrenia. Methods: A simple pre-and post experimental study with a three month follow-up was conducted to determine the efficacy of cognitive training in speed of processing and executive functions improving cognition in 22 schizophrenia patients. Results: Significant improvement was found in those cognitive domains specifically targeted in the training protocol, but also to a limited extent on verbal memory and social cognition. There was also evidence of improvements in symptoms and social functioning. The training effects failed to transfer to community functioning skills however. Except for social cognition, these improvements were maintained at 3 month follow-up. Conclusion: The study highlights the importance of understanding the mechanisms that contribute to the transfer of skills as well as the maintenance of cognitive changes in individuals with schizophrenia.
Psychological Interventions for Schizophrenia
Schizophrenia Bulletin, 1995
This review examines the impact of dynamic and supportive psychotherapies (both individual and group) and psychosocial skills training on clinical and social outcomes for individuals with schizophrenia. The relatively few controlled trials of individual or group psychotherapies for persons with schizophrenia exhibit serious methodological problems that limit their generalizability. Reality-oriented approaches appear to be superior to dynamic, insight-oriented psychotherapies, but further research is needed to identify and evaluate disorderspecific models that target specific deficits and disabilities in schizophrenia. Research on psychosocial skills training models shows that target skills can be trained and maintained over time. Further work is needed to determine the extent to which trained skills generalize from the original training setting to "real life" environments.
Rehabilitation Nursing, 2015
Purpose: This study was performed for the purpose of determining the effect of psychosocial skills training (PSST) on disease symptoms, insight, internalized stigmatization, and social functioning in patients with schizophrenia. Design: One group pretest-posttest model. Method: The study was carried out with 25 outpatients who were diagnosed with schizophrenia. The PSST was given to three groups of eight to nine patients once a week in 24 sessions, each lasting 90-120 minutes for a period of 6 months. Findings: The program had significant results in schizophrenic patients in improving the level of symptoms, increasing the level of functioning, and coping with stigmatization. Conclusion: The PSST program, adjuvant to pharmacological treatments, can be considered as a significant modality in daily practice due to its effect on improving symptoms, insight, and level of functioning and decreasing internalized stigmatization. Clinical Relevances: PSST in patients with schizophrenia can contribute to the use of evidence-based education strategies in psychiatric nursing practice to improve coping skills with the disease.
Patient Preference and Adherence, 2015
Background: The long-term course of schizophrenia is often characterized by relapses, induced by poor medication adherence. Early nonadherence after discharge is frequent. Objective: To evaluate a skills-based inpatient training program for medication intake. Methods: We developed a manual-based inpatient medication training program to be carried out by nurses and focusing on practical skills enabling autonomous intake of medication. Medication adherence was measured by three different methods: pill count, determination of serum levels, and self-assessment by the patient. The raters were blinded. Results: Four weeks after discharge, 98% of the patients in the intervention group (N=52) were rated as adherent by pill count versus 76% in the control group (N=50; P0.01). By measurement of serum level, 88.5% versus 70% were adherent (P0.05). Conclusion: The inpatient medication training program carried out by nurses seems to be an effective intervention for enhancing medication adherence after hospital discharge.