Training hospitalized patients with schizophrenia in community reintegration skills.

Abstract

The study examined the effectiveness of the Community Re-Entry Program, a brief, time-limited skills training module designed to help acutely ill inpatients become engaged in community-based treatment programs. Of 84 consecutive admissions to a chronic psychotic disorders unit, 44 completed assessments and attended the Community Re-Entry Program. The program consists of 16 daily small-group therapy sessions that engage the patient in efforts to define discharge readiness, identify symptoms and medication effects, and assist with discharge planning. Skill levels and positive and negative symptoms were assessed on admission and on completion of training, and a subsample of patients received two-week postdischarge follow-up assessments. From admission to discharge, positive symptoms diminished substantially, negative symptoms diminished to a lesser but statistically significant degree, and skill levels increased significantly. Posttraining skill level was predicted by pretraining skill level and level of participation in the skills training module. Patients' symptom levels did not predict participation in the program or skill acquisition. Skill level at discharge was also more predictive of two-week postdischarge community adjustment than were symptom levels. Although further controlled studies are required to fully establish the efficacy of the Community Re-Entry Program, these data suggest that brief, focused skills training may play an important role in augmenting optimal pharmacotherapy for hospitalized patients with chronic psychotic disorders.