A psychosocial skills training approach in Mexican out-patients with schizophrenia

2007 ◽  
Vol 37 (10) ◽  
pp. 1393-1402 ◽  
Author(s):  
MARCELO VALENCIA ◽  
MARIA LUISA RASCON ◽  
FRANCISCO JUAREZ ◽  
ESTHER MUROW
Keyword(s):  
Effect Size ◽  
Psychosocial Functioning ◽  
Negative Symptoms ◽  
Skills Training ◽  
Drop Out ◽  
Global Functioning ◽  
Treatment As Usual ◽  
Psychosocial Skills ◽  
Standardized Effect Sizes ◽  
Psychosocial Skills Training

ABSTRACTBackgroundThe effectiveness of a psychosocial skills training (PSST) approach applied to chronic out-patients with schizophrenia was examined. We hypothesized that the PSST programme, which included treatment as usual (TAU), PSST and family therapy (FT), would reduce positive and negative symptoms, prevent relapse and rehospitalization, and improve psychosocial functioning (PSF), global functioning and treatment adherence.MethodEighty-two patients were randomly assigned to receive either TAU [antipsychotic medication (AP); n=39] or the PSST approach (TAU+PSST+FT; n=43). The two groups were assessed at intake and after completion of 1 year of treatment.ResultsThere were statistically significant differences between the two groups. Patients in the PSST group improved their symptomatology, psychosocial and global functioning (symptoms and psychological, social and occupational functioning), showed lower relapse, rehospitalization and drop-out rates, a higher level of compliance with AP medication, and a high level of therapeutic adherence in comparison with TAU patients, whose symptoms also improved although they showed no improvement in any of the clinical or psychosocial variables. A comparison of the standardized effect sizes showed a medium and a large effect size of PSF and global functioning for the PSST group and a non-effect size for the TAU group.ConclusionsA higher level of effectiveness was demonstrated when combining TAU, PSST and FT in comparison with AP medication alone. The PSST approach should be recommended for clinical practice.

A broad-based remediation approach: The integrated neurocognitive therapy (INT)

2011 ◽  
Vol 26 (S2) ◽  
pp. 2159-2159 ◽  
Author(s):  
V. Roder ◽  
D.R. Mueller ◽  
S.J. Schmidt
Keyword(s):  
Cognitive Functions ◽  
Psychosocial Functioning ◽  
Negative Symptoms ◽  
Social Cognitive ◽  
Drop Out ◽  
Treatment As Usual ◽  
Anova Model ◽  
Therapeutic Principles ◽  
Distal Outcome

ObjectiveCognitive functions have a decisive influence and prognostic value for functional recovery. The NIMH MATRICS initiative established a consensus on neuro-cognitive and social cognitive domains relevant for the treatment of schizophrenia. Against this background we developed the Integrated Neurocognitive Therapy (INT) covering all MATRICS domains. INT is strongly based on therapeutic principles of the Integrated Psychological Therapy (IPT) designed by our research team several years ago. INT is partly computer based and intends to restitute and compensate neuro-cognitive and social cognitive functions.MethodsINT was evaluated in an international multi-cite RCT with centers in Switzerland, Germany, and Austria. The Swiss National Science Foundation supported this study. INT was compared with a treatment as usual control condition (TAU). INT patients received 30 therapy sessions twice a week. 169 schizophrenia outpatients participated in the study.ResultsUsing an ANOVA model, INT groups show superior effects after therapy and 1-year follow-up in proximal outcomes of neuro- and social cognition. Significant effects are evident in most of the MATRICS-domains. Additionally, significant effects in more distal outcomes are evident for INT patients in psychosocial functioning and negative symptoms after therapy and at follow-up. A low drop-out rate of 12% of the INT patients indicates a high acceptance by the patients.ConclusionsResults support evidence for the efficacy of INT in proximal and distal outcome dimensions. Further evaluations on INT have to investigate its relevance for different psychotic populations such as young early psychotics and more chronic older patients.

scholarly journals Efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL) in early psychosis: Results from the multi-center INTERACT randomized controlled trial

2021 ◽  
Author(s):  
Inez Myin-Germeys ◽  
Evelyne van Aubel ◽  
Thomas Vaessen ◽  
Henrietta Steinhart ◽  
Annelie Klippel ◽  
...  
Keyword(s):  
Acceptance And Commitment Therapy ◽  
Symptom Severity ◽  
Negative Symptoms ◽  
Primary Outcome ◽  
Daily Life ◽  
Post Intervention ◽  
Global Functioning ◽  
Treatment As Usual ◽  
Acceptance And Commitment

Importance Treatment in the early stages of psychosis is crucial to prevent poor clinical and social outcomes. Currently, no preventive interventions are available that reduce psychotic distress, or affective and negative symptoms as well as functioning, calling for more and dedicated treatments for these. Objective To investigate the efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL), combining face-to-face therapy with an Ecological Momentary Intervention (EMI), in addition to treatment as usual for psychotic distress, in comparison to treatment as usual only. Design This single-blinded randomized clinical INTERACT trial investigated participants post-intervention and at 6 and 12-month follow-up. Participants were recruited between June 1, 2015 and December 31, 2018. Assessors were blinded to treatment allocation. Setting INTERACT is a multi-center trial recruiting participants from secondary mental health services in 5 regions in Belgium and The Netherlands. Participants The sample was a referral sample of individuals aged 15-65 years with a clinically established UHR or FEP status. Interventions Individuals were randomly assigned (1:1) to ACT-DL, consisting of 8 ACT sessions augmented with an EMI app in addition to treatment as usual, or to treatment as usual only. Main outcomes and measures The primary outcome was a reduction in psychotic distress as assessed with CAARMS at post-intervention, 6- and 12-month follow-up. Secondary outcomes included symptom severity (measured with BPRS and BNNS), functioning (measured with SOFAS and SFS) and momentary psychotic distress (measured with the Experience Sampling Method, a structured diary technique). All analyses were described in the trial protocol and in a postregistration on the open-science framework, prior to accessing the data. Results Of the 196 individuals assessed for eligibility, 148 were randomized to ACT-DL+TAU (n=71) or TAU (n=77) (72 female (49%), average age 25 (SD = 6), 71 FEP (48%)). 115 (78%) provided primary outcome data at least at one follow-up assessment. There was no evidence of a greater reduction in CAARMS distress in ACT-DL+TAU compared to TAU (χ2(3)=2.38; p=.50). However, general psychopathology (χ2(3)=14.44; p=.002); affective (χ2(3)=8.55; p=.04) and negative symptom severity (χ2(3)=19.96; p<.001) as measured with the BPRS was reduced, as well as negative symptoms as assessed with BNNS (χ2(3)=15.96; p=.001) in. Furthermore, global functioning improved (χ2(3)=8.72; p=.033) in ACT-DL+TAU compared to TAU, whereas social functioning failed to reach significance (χ2(3)=7.41; p=.060). Finally, a clear and significant reduction was found in momentary psychotic distress (χ2(3)=21.56; p<0.001), whereas no effects were found for momentary psychotic experiences (χ2(3)=1.02; p=.599), momentary positive (χ2(3)=4.17; p=.124) or negative (χ2(3)=2.78; p=.249) affect. No serious adverse events directly related to the therapy occurred. Conclusions and relevance INTERACT did not support a significant effect on psychotic distress as assessed with the CAARMS. However, significant improvements were found for momentary psychotic distress, global functioning and negative symptomatology. These results are promising given that these latter problems are among the hardest to treat.

A systematic review of interventions to foster physician resilience

2017 ◽  
Vol 94 (1109) ◽  
pp. 162-170 ◽  
Author(s):  
Susan Fox ◽  
Sinéad Lydon ◽  
Dara Byrne ◽  
Caoimhe Madden ◽  
Fergal Connolly ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Best Practice ◽  
English Language ◽  
Reference Lists ◽  
Skills Training ◽  
Healthcare Settings ◽  
Psychosocial Skills ◽  
Rigorous Research ◽  
Psychosocial Skills Training

This review aimed to synthesise the literature describing interventions to improve resilience among physicians, to evaluate the quality of this research and to outline the type and efficacy of interventions implemented. Searches were conducted in April 2017 using five electronic databases. Reference lists of included studies and existing review papers were screened. English language, peer-reviewed studies evaluating interventions to improve physician resilience were included. Data were extracted on setting, design, participant and intervention characteristics and outcomes. Methodological quality was assessed using the Downs and Black checklist. Twenty-two studies were included. Methodological quality was low to moderate. The most frequently employed interventional strategies were psychosocial skills training and mindfulness training. Effect sizes were heterogeneous. Methodologically rigorous research is required to establish best practice in improving resilience among physicians and to better consider how healthcare settings should be considered within interventions.

scholarly journals S39. THE IMPACT OF THE GROUP FACTOR ON OUTCOME IN GROUP THERAPY: FINAL RESULTS OF RCT INCLUDING 127 SCHIZOPHRENIA OUTPATIENTS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S46-S47
Author(s):  
Daniel Mueller ◽  
Conny Steichen ◽  
Kristin Schaller ◽  
Volker Roder
Keyword(s):  
Group Therapy ◽  
Negative Symptoms ◽  
Therapy Group ◽  
Cognitive Remediation ◽  
Skills Training ◽  
Group Factor ◽  
Treatment As Usual ◽  
Before And After ◽  
Comparison Groups ◽  
The Impact

Abstract Background Today, some evidence-based group therapy approaches focusing different treatment goals are available for the treatment of schizophrenia patients, e.g. psychoeducation, social skills training, CBTp or cognitive remediation. However, only few if any data are available regarding the impact of the group factor as an unspecific mechanism of change regarding outcome in schizophrenia patients. Does the participation in goal-oriented groups per se affect therapy outcome? Methods To bridge this gap, a cognitive remediation group approach (Integrated Neurocognitive Therapy, INT) developed in our lab has been compared with control patients not participating in therapy groups (Treatment as Usual, TAU). A total of 127 schizophrenia outpatients has been randomly assigned to INT (N=65) or TAU (n=62). INT was conducted twice a week over 15 weeks therapy duration. A comprehensive test battery was assessed before and after therapy as well as at 1-year follow up in both comparison groups. The group factor was assessed by the newly developed questionnaire “Experience and Behavior in Therapy groups EBIT”, a brief questionnaire including 13 items. Results The therapy group showed significantly better effects in EBIT outcome compared to controls regarding the global score (mean of all EBIT items) (GLM: F=4.23, p=.02) as well as regarding empirical 2-factor solution using factor analysis: factor 1 (affect and communication skills) (GLM: F=3.70; p=.03) and factor 2 (eye contact during communication) (F=3.35, p=.04). Additionally, EBIT scores are significantly associated with improvement in cognition and negative symptoms after treatment but not with positive symptoms. Discussion First of all, the group factor can be identified and measured using a brief questionnaire. Additionally, the group factor has a supplement positive effect on cognition and negative symptoms.

Psychosocial/non-pharmacologic treatment of negative symptoms

2020 ◽  
pp. 87-106
Author(s):  
Mark Savill
Keyword(s):  
Music Therapy ◽  
Best Practice ◽  
Negative Symptoms ◽  
Skills Training ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Behavioural Therapies ◽  
Family Based ◽  
The Impact

Current best practice regarding the treatment of negative symptoms of schizophrenia supports the use of psychological interventions in addition to medication. This chapter reviews the literature evaluating different non-pharmacological approaches to treating these symptoms. Meta-analytic studies suggest that social skills training, music therapy, non-invasive brain stimulation, mindfulness, and exercise-based interventions are all effective at improving negative symptoms, relative to treatment as usual (TAU). Effect sizes for these interventions range from small to moderate. The long-term benefits of these interventions are currently unclear, and there has been some debate as to whether the impact of these interventions constitute consistent, clinically meaningful change. Evidence for other therapies such as arts therapies other than music therapy, cognitive behavioural therapies for psychosis, neurocognitive therapies, and family-based interventions is more inconsistent. As a result, primary negative symptoms of schizophrenia can still be considered an important unmet therapeutic need where more research is needed.

scholarly journals Effectiveness of Integrated Neurocognitive Therapy on Cognitive Impairment and Functional Outcome for Schizophrenia Outpatients

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Andreana De Mare ◽  
Miriam Cantarella ◽  
Giovanni Galeoto
Keyword(s):  
Cognitive Impairment ◽  
Functional Outcome ◽  
Effect Size ◽  
Negative Symptoms ◽  
Social Cognitive ◽  
Meta Analysis ◽  
Positive Symptoms ◽  
Global Functioning ◽  
Cognitive Domains ◽  
Treatment Research

Cognitive impairment is highly prevalent in patients with schizophrenia and schizoaffective disorder. Many interventions have been developed to treat cognitive deficit, since it has a strong impact on functional outcome; however, there are no integrated interventions targeting multiple neuro- and social-cognitive domains with a particular focus on the generalization of the effects of therapy on the functional outcome. Recently, a group of experts has developed a cognitive remediation group therapy approach called Integrated Neurocognitive Therapy (INT), which includes exercises to improve the MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) neuro- and social-cognitive domains. This systematic review and meta-analysis aimed to assess the efficacy of this approach. We conducted a search of PubMed, Scopus, Web of Science, and PsycINFO to select primary studies evaluating INT in schizophrenic and schizoaffective patients. The primary outcomes of the meta-analysis included negative and positive symptoms and global functioning. Two randomized controlled trials met inclusion criteria. A total of 217 participants were included. Based on the results from the Positive and Negative Syndrome Scale (PANSS), a significant pooled effect size was observed for negative symptoms, which demonstrated not only an improvement in the patients treated immediately after therapy but also a permanence of positive results at a 9–12-month follow-up. On the other hand, no significant effect size was observed for positive symptoms. In addition, a significant pooled effect size was found for Global Assessment of Functioning (GAF), which shows how INT’s integrated approach has lasting positive implications on patients’ functional outcome. We concluded that INT might be an effective treatment for negative symptoms and global functioning in patients with schizophrenia, compared to treatment as usual (TAU).

Effect of Psychosocial Skills Training on Disease Symptoms, Insight, Internalized Stigmatization, and Social Functioning in Patients with Schizophrenia

2015 ◽  
Vol 40 (6) ◽  
pp. 341-348 ◽  
Author(s):  
Arzu Yıldırım ◽  
Rabia Hacıhasanoğlu Aşılar ◽  
Tuba Hale Camcıoğlu ◽  
Sezgin Erdiman ◽  
Ebru Karaağaç
Keyword(s):  
Social Functioning ◽  
Skills Training ◽  
Disease Symptoms ◽  
Psychosocial Skills ◽  
Psychosocial Skills Training

Test of Mindfulness-Based Psychosocial Skills Training to İmprove Insight and Functional Recovery in Schizophrenia

2017 ◽  
Vol 40 (9) ◽  
pp. 1357-1373 ◽  
Author(s):  
Emine Yılmaz ◽  
Ayşe Okanlı
Keyword(s):  
Functional Recovery ◽  
Personal Information ◽  
Training Group ◽  
Skills Training ◽  
Control Group ◽  
Standard Drug ◽  
Psychosocial Skills ◽  
Cognitive Insight ◽  
And Control ◽  
Psychosocial Skills Training

This study was conducted with two groups (training and control) using a pretest/posttest design to determine the effect of mindfulness-based psychosocial skills training for improving insight and functional recovery levels in patients with schizophrenia. The study sample included 45 patients with schizophrenia (21 were in the training group/mindfulness-based psychosocial skills training and 24 were in the control group/standard drug medication). The data were collected using a Personal Information Form, Functional Remission of General Schizophrenia (FROGS) scale, and Beck Cognitive Insight Scale (BCIS). The training group was divided into two groups of 10 to 12 persons on average. Training was given as a group training for a total of 16 sessions, two sessions a week for 8 weeks. The training group scored significantly higher in functional recovery and insight levels than the control group after training ( p < .05). The study determined training has an effect on increasing the levels of insight and functional recovery in schizophrenia.

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