Social Skills Training For Schizophrenia Research Articles

Intranasal Oxytocin Combined With Social Skills Training for Schizophrenia: An Add-on Randomized Controlled Trial.

Some but not other studies on oxytocin for schizophrenia, particularly those using a higher dose, indicate that oxytocin improves negative symptoms of schizophrenia. We performed an add-on randomized controlled trial to examine the effect of high-dose oxytocin, social skills training, and their combination in the treatment of negative symptoms and social dysfunction in schizophrenia. Fifty-one subjects with schizophrenia were randomized, employing a two-by-two design: intranasal oxytocin (24 IU X3/day) or placebo, and social skills training or supportive psychotherapy, for 3 weeks. The primary outcome was the difference in the total score from baseline to end-of-study of a semi-structured interview which assessed patients' social interactions in 3 scenarios: sharing a positive experience, sharing a conflict, and giving support when the experimenter shared a conflict. The interactions were scored using the Coding Interactive Behavior Manual (CIB), clinical symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). No significant difference was found between groups in the total CIB or PANSS scores. The majority of comparisons in the different social interactions between oxytocin and placebo, and between social skills training vs supportive psychotherapy, were also nonsignificant. Social skills training reduced blunted affect and gaze. In post-hoc analyses of the support interaction, oxytocin improved synchrony and decreased tension, while in the positive interaction it improved positive affect and avoidance. None of these findings remained significant when controlling for multiple comparisons. In conclusion, oxytocin did not influence participants' social behavior, and was not effective in improving the symptoms of schizophrenia. Clinicaltrials.gov Identifier: NCT01598623.

Improvement in Negative Symptoms and Functioning in Cognitive-Behavioral Social Skills Training for Schizophrenia: Mediation by Defeatist Performance Attitudes and Asocial Beliefs

Psychosocial interventions have significant but modest impact on negative symptoms and functioning in schizophrenia. Identifying mechanisms of change in these interventions can inform treatment targets to strengthen these interventions. A number of studies have found associations between dysfunctional attitudes negative symptoms and functioning in schizophrenia. We previously found improvement in experiential negative symptoms and functioning in cognitive-behavioral social skills training (CBSST) in participants with schizophrenia (N = 149), and the present study examined whether improvements in CBSST in that trial were mediated by the group effect on defeatist performance attitudes and asocial beliefs. In multilevel mediation analyses, the effect of treatment group on experiential negative symptoms and functioning was mediated prospectively through defeatist attitudes but asocial beliefs only mediated effects on experiential negative symptoms. The findings suggest that cognitive-behavioral therapy interventions that target dysfunctional attitudes can lead to improvement in negative symptoms and functioning in schizophrenia.

Enhancing assertive community treatment with cognitive behavioral social skills training for schizophrenia: study protocol for a randomized controlled trial.

BackgroundSchizophrenia leads to profound disability in everyday functioning (e.g., difficulty finding and maintaining employment, housing, and personal relationships). Medications can effectively reduce positive symptoms (e.g., hallucinations and delusions), but they do not meaningfully improve daily life functioning. Psychosocial evidence-based practices (EBPs) improve functioning, but these EBPs are not available to most people with schizophrenia. The field must close the research and service delivery gap by adapting EBPs for schizophrenia to facilitate widespread implementation in community settings. Our hybrid effectiveness and implementation study represents an initiative to bridge this divide. In this study we will test whether an existing EBP (i.e., Cognitive Behavioral Social Skills Training (CBSST)) modified to work in practice settings (i.e., Assertive Community Treatment (ACT) teams) commonly available to persons with schizophrenia results in better consumer outcomes. We will also identify key factors relevant to developing future CBSST implementation strategies.Methods/DesignFor the effectiveness study component, persons with schizophrenia will be recruited from existing publicly funded ACT teams operating in community settings. Participants will be randomized to one of the 2 treatments (ACT alone or ACT + Adapted CBSST) and followed longitudinally for 18 months with assessments every 18 weeks after baseline (5 in total). The primary outcome domain is psychosocial functioning (e.g., everyday living skills and activities related to employment, education, and housing) as measured by self-report, testing, and observation. Additional outcome domains of interest include mediators of change in functioning, symptoms, and quality of services. Primary analyses will be conducted using linear mixed-effects models for continuous data. The implementation study component consists of a structured, mixed qualitative-quantitative methodology (i.e., Concept Mapping) to characterize and assess the implementation experience from multiple stakeholder perspectives in order to inform future implementation initiatives.DiscussionAdapting CBSST to fit into the ACT service delivery context found throughout the United States creates an opportunity to substantially increase the number of persons with schizophrenia who could have access to and benefit from EBPs. As part of the implementation learning process training materials and treatment workbooks have been revised to promote easier use of CBSST in the context of brief community-based ACT visits.Trial registrationClinicalTrials.gov NCT02254733. Date of registration: 25 April 2014.

Cognitive insight and functioning outcomes in cognitive behavioral social skills training for schizophrenia

Cognitive insight and functioning outcomes in cognitive behavioral social skills training for schizophrenia

Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: improvement in functioning and experiential negative symptoms.

Identifying treatments to improve functioning and reduce negative symptoms in consumers with schizophrenia is of high public health significance. In this randomized clinical trial, participants with schizophrenia or schizoaffective disorder (N = 149) were randomly assigned to cognitive behavioral social skills training (CBSST) or an active goal-focused supportive contact (GFSC) control condition. CBSST combined cognitive behavior therapy with social skills training and problem-solving training to improve functioning and negative symptoms. GFSC was weekly supportive group therapy focused on setting and achieving functioning goals. Blind raters assessed functioning (primary outcome: Independent Living Skills Survey [ILSS]), CBSST skill knowledge, positive and negative symptoms, depression, and defeatist performance attitudes. In mixed-effects regression models in intent-to-treat analyses, CBSST skill knowledge, functioning, amotivation/asociality negative symptoms, and defeatist performance attitudes improved significantly more in CBSST relative to GFSC. In both treatment groups, comparable improvements were also found for positive symptoms and a performance-based measure of social competence. The results suggest CBSST is an effective treatment to improve functioning and experiential negative symptoms in consumers with schizophrenia, and both CBSST and supportive group therapy actively focused on setting and achieving functioning goals can improve social competence and reduce positive symptoms.

Effects of combination pharmacotherapy and social skills training for schizophrenia: A randomized controlled trial

Pharmaco-psychosocial treatment (PPST) refers to a treatment paradigm combining pharmacotherapy with psychosocial therapy. We conducted an 18-month randomized controlled tracking study to evaluate the efficacy of social skills training (SST) in 11 individuals with schizophrenia on risperidone monotherapy. They were randomized to either SST or non-SST group, and Global Assessment Functioning (GAF) and Brief Psychiatric Rating Scale (BPRS) scores in the 2 groups showed gradual improvement. In the SST group, Digit Span Distraction Test (DSDT) at 12 and 18 months showed significant improvement. The Subjective Deficit Syndrome Scale (SDSS) scores in the SST group showed significant improvement after 6 months and showed a significant difference in comparison between the groups. After the subjective feeling of health was recovered, the items of motivation were recovered as a direct effect of SST. Some items of the Life Assessment Scale for the Mentally Ill (LASMI) score showed significant improvement (or significant trend) in only the SST group after 6 months. Items of daily life, work skills, and self-recognition were continuously improved. We report 2 cases in the SST group that had DSDT improvement in parallel with change of action and communication as a change of social function. This study is only exploratory due to the small number of cases. However, we have demonstrated potential improvement in cognitive function due to learning experiences that required working memory and attention, thus providing improvement in social life.

A virtual reality application in role-plays of social skills training for schizophrenia: A randomized, controlled trial

Although social skills training (SST) is an effective approach for improving social skills for schizophrenia, the motivational deficit attenuates its efficacy. Virtual reality (VR) applications have allowed individuals with mental disabilities to enhance their motivation for rehabilitations. We compared SST using VR role-playing (SST-VR) to SST using traditional role-playing (SST-TR). This randomized, controlled trial included 91 inpatients with schizophrenia who were assigned to either SST-VR ( n = 46) or SST-TR ( n = 45). Both groups were administered over 10 semiweekly group sessions. An experienced, blinded rater assessed vocal, nonverbal and conversational skills. We also obtained data on motivation for SST and various social abilities. Throughout the 10 sessions, the SST-VR group ( n = 33) showed greater interest in SST and generalization of the skills than the SST-TR group ( n = 31). After SST, the SST-VR group improved more in conversational skills and assertiveness than the SST-TR group, but less in nonverbal skills. The VR application in role-plays of SST for schizophrenia may be particularly beneficial in terms of improving the conversational skills and assertiveness, possibly through its advantages in enhancing motivation for SST and generalization of the skills, and thus it may be a useful supplement to traditional SST.

Social skills training for schizophrenia

Social skills training for schizophrenia

57 – A meta-analysis of controlled research on social skills training for schizophrenia

57 – A meta-analysis of controlled research on social skills training for schizophrenia

A meta-analysis of controlled research on social skills training for schizophrenia.

A meta-analysis of randomized, controlled trials of social skills training for schizophrenia was conducted. Outcome measures from 22 studies including 1,521 clients were categorized according to a proximal-distal continuum in relation to the presumed site of action of skills training interventions, with content mastery tests and performance-based measures of skills assumed to be most proximal, community functioning and negative symptoms intermediate, and general symptoms and relapse most distal. Results reveal a large weighted mean effect size for content-mastery exams (d = 1.20), a moderate mean effect size for performance-based measures of social and daily living skills (d = 0.52), moderate mean effect sizes for community functioning (d = 0.52) and negative symptoms (d = 0.40), and small mean effect sizes for other symptoms (d = 0.15) and relapse (d = 0.23). These results support the efficacy of social skills training for improving psychosocial functioning in schizophrenia.

Recent Advances in Social Skills Training for Schizophrenia

Social skills training consists of learning activities utilizing behavioral techniques that enable persons with schizophrenia and other disabling mental disorders to acquire interpersonal disease management and independent living skills for improved functioning in their communities. A large and growing body of research supports the efficacy and effectiveness of social skills training for schizophrenia. When the type and frequency of training is linked to the phase of the disorder, patients can learn and retain a wide variety of social and independent living skills. Generalization of the skills for use in everyday life occurs when patients are provided with opportunities, encouragement, and reinforcement for practicing the skills in relevant situations. Recent advances in skills training include special adaptations and applications for improved generalization of training into the community, short-term stays in psychiatric inpatient units, dually diagnosed substance abusing mentally ill, minority groups, amplifying supported employment, treatment refractory schizophrenia, older adults, overcoming cognitive deficits, and negative symptoms as well as the inclusion of social skills training as part of multidimensional treatment and rehabilitation programs.

A Review of: “Social Skills Training for Schizophrenia (Second Edition) A Step-by-Step Guide”

A Review of: “Social Skills Training for Schizophrenia (Second Edition) A Step-by-Step Guide”

Social Skills Training for Schizophrenia

Article AbstractThe enhancement of social skills may be pivotal in our patients with schizophrenia, raising their baseline level of function and allowing achievement of their goals, thereby reducing rehospitalizations. Social Skills Training for Schizophrenia provides the formula to achieve this end. It is one of the volumes in the "Treatment Manuals for Practitioners" series, which is edited by David H. Barlow. This volume is a collaborative product of 4 clinicians who distill the learning of the past 30 years in the field along with the recent neurocognitive research, resulting in an up-to-date integration for this modality of psychiatric rehabilitation.

Social skills training for schizophrenia: Review and future directions

A significant amount of progress has been made in documenting the effectiveness of social skills training strategies for schizophrenia. In an effort to update the literature, the authors first discuss definitions of social skill, competence, and adjustment. Following this, the skills training studies of the past decade are reviewed. These studies indicate several areas in which skills training approaches are useful, and also many areas wherein further modification of techniques is required. Future directions are proposed, with recommendations made regarding the need for: (a) highly focused training protocols; (b) more rigorous assessment of skill generalization and outcome; (c) strategies for clarifying the interrelationships between schizophrenic symptoms, antipsychotic medications, and social skills; and (d) documentation of the increasingly important role of neurocognition in mediating social skill, skill acquisition, and social competence in schizophrenia.

Social Skills Training for Schizophrenia?-Reply

<h3>In Reply.—</h3> We are grateful to Drs Bel- lack and Mueser for their interest in our work and for their generally supportive comments. They raise the following two apparent concerns: (1) our alleged view that psychosocial treatment, particularly social skills training (SST), is "overly pessimistic," and (2) the possibility that patients experiencing late relapses might not develop the social skills needed for survival, an indictment of our "particular intervention," rather than SST itself. First, we know of no SST application among schizophrenic patients that has ever demonstrated persistent effects relative to controls for more than 9 months after discharge, including the important study by Bellack et al.¹In fact, the least equivocal effects of SST with schizophrenic pa- tients seem best identified immediately after termination of brief treatment, most often among hospitalized male patients.²As such, our results indicating an effect on relapse at 1 year, as well as effects

Predicting skill acquisition in social skills training for schizophrenia and schizoaffective disorder: The role of memory and symptomatology

Predicting skill acquisition in social skills training for schizophrenia and schizoaffective disorder: The role of memory and symptomatology