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 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.

scholarly journals Prospective mental imagery in depression: Impact on reward processing and reward-motivated behaviour

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Fritz Renner ◽  
Jessica Werthmann ◽  
Andreas Paetsch ◽  
Hannah E. Bär ◽  
Max Heise ◽  
...  
Keyword(s):  
Mental Imagery ◽  
Mechanistic Model ◽  
Reward Processing ◽  
Future Research ◽  
Clinical Implementation ◽  
Cognitive Behavioural ◽  
Behavioural Therapies ◽  
Processing Motivation ◽  
Reward Motivation ◽  
The Impact

Background Mental imagery has long been part of cognitive behavioural therapies. More recently, a resurgence of interest has emerged for prospective mental imagery, i.e. future-directed imagery-based thought, and its relation to reward processing, motivation and behaviour in the context of depression. Method We conducted a selective review on the role of prospective mental imagery and its impact on reward processing and reward-motivated behaviour in depression. Results Based on the current literature, we propose a conceptual mechanistic model of prospective mental imagery. Prospective mental imagery of engaging in positive activities can increase reward anticipation and reward motivation, which can transfer to increased engagement in reward-motivated behaviour and more experiences of reward, thereby decreasing depressive symptoms. We suggest directions for future research using multimodal assessments to measure the impact of prospective mental imagery from its basic functioning in the lab to real-world and clinical implementation. Conclusion Prospective mental imagery has the potential to improve treatment for depression where the aim is to increase reward-motivated behaviours. Future research should investigate how exactly and for whom prospective mental imagery works.

scholarly journals Cognitive behavioural therapies versus treatment as usual for depression

2010 ◽  
Author(s):  
Vivien Hunot ◽  
Theresa HM Moore ◽  
Deborah Caldwell ◽  
Philippa Davies ◽  
Hannah Jones ◽  
...  
Keyword(s):  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Behavioural Therapies ◽  
Versus Treatment

Recruitment to a trial of self-care skills training in long-term health conditions: Analysis of the impact of patient attitudes and preferences

2006 ◽  
Vol 27 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Peter Bower ◽  
Anne Kennedy ◽  
David Reeves ◽  
Claire Gately ◽  
Victoria Lee ◽  
...  
Keyword(s):  
Self Care ◽  
Skills Training ◽  
Health Conditions ◽  
Patient Attitudes ◽  
The Impact

Schoolinary art: practical cooking skills issues for the future

2015 ◽  
Vol 117 (2) ◽  
pp. 629-650 ◽  
Author(s):  
Dawn Mc Dowell ◽  
Una McMahon-Beattie ◽  
Amy Burns
Keyword(s):  
Low Income ◽  
Policy Decision ◽  
Skills Training ◽  
Time Frame ◽  
Home Economics ◽  
Structured Learning ◽  
Content Type ◽  
Cooking Skills ◽  
The Impact

Purpose – The purpose of this paper is to consider the importance of structured and consistent practical cookery skills intervention in the 11-14-year age group. This paper reviews the impact and development of statutory and non-statutory cooking skills interventions in the UK and considers limitations in relation to life skills training. Currently practical cooking skills are mainly derived from two sources namely the non-statutory sector (community cooking interventions) and the statutory sector (Home Economics teaching). Design/methodology/approach – The paper compares the two interventions in terms of effective long-term outcomes. Non-statutory cooking interventions are generally lottery funded and therefore tend to be single teaching blocks of, on average, six to eight weeks targeting mostly low-income adults and the literature emphasises a deficit of empirical measurement of the long-term impact. In contrast Home Economics classes offer a structured learning environment across genders and socio-economic groups. In addition it is taught over a substantial time frame to facilitate a process of practical skills development (with relevant theoretical teaching), reflection, group communication and consolidation, where according to current educational theory (Kolb, 1984) learning is more thoroughly embedded with the increased potential for longer term impact. Findings – The review identifies the limitations of too many community initiatives or “project-itis” (Caraher, 2012, p. 10) and instead supports the use of the school curriculum to best maximise the learning of practical cooking skills. Originality/value – This review will be of particular value to educationalists and health policy decision makers.

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.

scholarly journals Balneotherapy Together with a Psychoeducation Program for Benzodiazepine Withdrawal: A Feasibility Study

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
P. De Maricourt ◽  
P. Gorwood ◽  
Th. Hergueta ◽  
A. Galinowski ◽  
R. Salamon ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Behavioural Therapy ◽  
Public Health Issue ◽  
Depression Symptoms ◽  
Cognitive Behavioural ◽  
Efficacy Outcome ◽  
Benzodiazepine Use ◽  
Benzodiazepine Withdrawal ◽  
The Impact

Benzodiazepines should be prescribed on a short-term basis, but a significant proportion of patients (%) use them for more than 6 months, constituting a serious public health issue. Indeed, few strategies are effective in helping patients to discontinue long-term benzodiazepine treatments. The aim of this study was to assess the feasibility and the impact of a program including cognitive behavioural therapy, psychoeducation, and balneotherapy in a spa resort to facilitate long-term discontinuation of benzodiazepines. We conducted a prospective multicentre cohort study. Patients with long-term benzodiazepine use were recruited with the aim of anxiolytic withdrawal by means of a psychoeducational program and daily balneotherapy during 3 weeks. The primary efficacy outcome measure was benzodiazepine use 6 months after the program, compared to use at baseline. A total of 70 subjects were enrolled. At 6 months, overall benzodiazepine intake had decreased by 75.3%, with 41.4% of patients completely stopping benzodiazepine use. The results also suggest a significantly greater improvement in anxiety and depression symptoms among patients who discontinued benzodiazepines compared to patients who only reduced their use. Our findings suggest that balneotherapy in association with a psychoeducative program is efficient in subjects with benzodiazepine addiction.

Frostbite: an ancient affliction – have we made progress? A case series and review of best practice.

2017 ◽  
Vol 103 (2) ◽  
pp. 114-119
Author(s):  
R J Thomas ◽  
K Heil ◽  
K Johnson ◽  
A M Wood
Keyword(s):  
Military Personnel ◽  
Best Practice ◽  
Early Recognition ◽  
Case Series ◽  
Current Evidence ◽  
Medical Facility ◽  
Preventative Measures ◽  
Field Environment ◽  
The Impact

AbstractFrostbite represents a spectrum of injuries that can have long term, permanent sequelae, resulting in lifelong disability of otherwise young, fit, economically active individuals. Furthermore, it is generally preventable. Military personnel are put at risk of this condition by the nature of their occupation. With preventative measures, early recognition, appropriate evacuation and repatriation to a medical facility, the impact of this condition can be minimised.This article describes a case series of Royal Marines who were medically evacuated due to frostbite during an exercise, and a review of current evidence supporting the management of frostbite in the field environment through to definitive care.

Carers and dementia

2020 ◽  
pp. 851-864
Author(s):  
Jan Oyebode ◽  
Sahdia Parveen
Keyword(s):  
Skills Training ◽  
Family Carers ◽  
Stress Appraisal ◽  
People With Dementia ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
Behavioural Therapies ◽  
And Coping ◽  
Person With Dementia

Family carers are vitally important to sustaining the quality of people with dementia, providing over half of dementia care. This chapter reviews the experience of family carers and how they can be supported. Carers face many transitions as dementia develops but generally caring has a broad impact on carers’ lives, affecting fulfilment of needs in a range of ways both practical and relational. Caring carries burden and mental health consequences with around 30% carers becoming depressed, however, it also provokes gains and satisfactions. A number of models are available to assist understanding, focused on stress, appraisal and coping, grief, and positive aspects. A range of interventions including psycho-educational programmes, skills training, supportive counselling, cognitive behavioural therapies, and multi-component programmes can reduce carer stress. Interventions that are effective involve the person with dementia and the carer, are flexible enough to be individually tailored and are intensive or involve active participation.

scholarly journals Cognitive behavioural therapies versus treatment as usual for depression

2018 ◽  
Author(s):  
Vivien Hunot ◽  
Theresa HM Moore ◽  
Deborah M Caldwell ◽  
Philippa Davies ◽  
Hannah F Jones ◽  
...  
Keyword(s):  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Behavioural Therapies ◽  
Versus Treatment
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