Mobile-assisted cognitive-behavioral social skills training in older adults with schizophrenia

Abstract

Abstract Psychosocial rehabilitation interventions are needed to improve functioning in people with schizophrenia, particularly for older adults. In multiple clinical trials, cognitive-behavioral social skills training (CBSST) has been found to improve community functioning in younger and older participants with schizophrenia. To reduce the burden and possibly strengthen CBSST, we developed a mobile-assisted CBSST intervention (MA-CBSST), in which therapist contact was reduced 50% and group sessions were supplemented by a mobile device that prompted at-home practice of CBSST skills. This study was a preliminary randomized clinical trial comparing: (1) the full CBSST program; (2) MA-CBSST and (3) a device contact (DC) control (only symptom and activity monitoring) in 57 older adults with schizophrenia (age > 45). Relative to DC-only, CBSST skill knowledge and self-reported functioning improved significantly more in the full CBSST program and full CBSST and MA-CBSST groups did not differ significantly, but improvements on these outcomes were only marginally significant for MA-CBSST relative to DC-only with smaller effect sizes. The results replicated multiple prior clinical trials showing improvement in functioning in schizophrenia in CBSST, but the effect of MA-CBSST on functioning was weaker than the full CBSST program.