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 Surgeons' Experience of Learning Psychological Skills: A Preliminary Evaluation of a Psychological Skills Training Course

2009 ◽  
Vol 91 (4) ◽  
pp. 321-325 ◽  
Author(s):  
Victoria Mason ◽  
Selina Balloo ◽  
Dominic Upton ◽  
Kamal Heer ◽  
Phil Higton ◽  
...  
Keyword(s):  
Human Factors ◽  
Focus Groups ◽  
Skills Training ◽  
Preliminary Evaluation ◽  
Psychological Skills ◽  
Surgical Performance ◽  
Psychological Skills Training ◽  
Before And After ◽  
Theory Practice Gap ◽  
The Impact

INTRODUCTION A range of human factors have been shown to impact on surgical performance although little is known about the impact of training on the views of surgeons towards these factors or how receptive surgeons are to such training. SUBJECTS AND METHODS This was an observational pilot study using a short questionnaire designed to elicit views of surgeons towards a range of human factors prior to, and immediately following, a course designed to address human factors in surgical performance. Focus groups were also conducted before and immediately after the course to elicit views. RESULTS Of all the human factors assessed, decision-making was rated on a visual analogue scale as having the biggest impact on performance both before and after the course. In general, views of human factors changed following the course, most notably an increase in the extent to which work stress, interpersonal difficulties and personality were believed to affect performance. Three themes emerged from the focus groups: (i) personal professional development; (ii) the relationship between trainer and trainee; and (iii) the changing perspective. CONCLUSIONS Surgeons from a range of specialties are receptive to training on the impact of human factors on performance and this study has shown that views may change following a course designed to address this. Further training to address the theory–practice gap is warranted in addition to an evaluation of its effectiveness.

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 The Use of Feedback in Group Counseling in a State Vocational Rehabilitation Setting

2016 ◽  
Vol 47 (4) ◽  
pp. 10-19
Author(s):  
Saara Grizzell ◽  
Julie Smart ◽  
Michael J. Lambert ◽  
Jamison Fargo
Keyword(s):  
Mental Health ◽  
Group Therapy ◽  
Vocational Rehabilitation ◽  
Interpersonal Relationships ◽  
Multilevel Models ◽  
Social Role ◽  
Treatment As Usual ◽  
Public Benefits ◽  
Feedback Interventions ◽  
The Impact

This study examined the impact of providing progress feedback to individuals with disabilities receiving services at a state vocational rehabilitation (VR) agency. Thirty individuals were randomly assigned to receive either group therapy (treatment-as-usual, TAU) or group therapy plus feedback (treatment, Fb) during a 10-week counseling program at one of five agency offices. Each week, participants attended a 90-minute session and completed a measure of mental health (Outcome Questionnaire-45). Longitudinal multilevel models were used to evaluate the hypothesis that participation in the Fb group would lead to improved mental health. The effect of the intervention was conditional on receipt of public benefits for three mental health outcomes: interpersonal relationships (p=.025); social role performance (p=.021), and overall mental healthfunctioning (p=.028). Additionally, a significantly greater proportion of participants were employed at the end of the study (p=0.012). Further research is needed to evaluate the efficacy of feedback interventions in VR settings.

scholarly journals Neuroplastic changes in patients with schizophrenia undergoing cognitive remediation: Triple-blind trial

2017 ◽  
Vol 210 (3) ◽  
pp. 216-222 ◽  
Author(s):  
Ian S. Ramsay ◽  
Tasha M. Nienow ◽  
Matthew P. Marggraf ◽  
Angus W. MacDonald
Keyword(s):  
Controlled Trial ◽  
Memory Task ◽  
Cognitive Remediation ◽  
Skills Training ◽  
Neural Activation ◽  
Cognitive Measures ◽  
Time Interaction ◽  
Before And After ◽  
Placebo Trial ◽  
Back Task

BackgroundPatients with schizophrenia have shown cognitive improvements following cognitive remediation, but the neuroplastic changes that support these processes are not fully understood.AimsTo use a triple-blind, placebo-controlled trial to examine neural activation before and after cognitive remediation or a computer skills training (CST) placebo (trial registration: NCT00995553)).MethodTwenty-seven participants underwent functional magnetic resonance imaging before and after being randomised to either cognitive remediation intervention or CST. Participants completed two variants of the N-back task during scanning and were assessed on measures of cognition, functional capacity, community functioning and symptoms.ResultsWe observed a group × time interaction in the left prefrontal cortex, wherein the cognitive remediation group showed increased activation. These changes correlated with improved task accuracy within the cognitive remediation group, whereas there was no relationship between changes in activation in untrained cognitive measures. Significant changes were not observed in other hypothesised areas for the cognitive remediation group.ConclusionsWe replicated the finding that cognitive remediation increases left lateral prefrontal activation during a working memory task in patients with schizophrenia, suggesting this may be an important neural target for these types of interventions.

scholarly journals Effect of Computerized Cognitive Remediation in Patients with Schizophrenia

2020 ◽  
Vol 8 (6) ◽  
pp. 1083-1087
Keyword(s):  
Cognitive Training ◽  
Effect Size ◽  
Digit Span ◽  
Controlled Trial ◽  
Cognitive Remediation ◽  
Large Effect Size ◽  
Treatment As Usual ◽  
Indian Patients ◽  
Before And After ◽  
Schizophrenic Patients

The objective of this study is to evaluate the effect of computerized cognitive remediation through 3 months randomized controlled trial in Indian patients with schizophrenia. Nineteen chronic schizophrenic patients were recruited and randomized into Cognitive Training (CT) and Treatment as Usual (TAU) groups. Neuropsychological assessments were done before and after 3 months of cognitive training on the developed program. As compared to TAU, the CT group exhibited significant improvement in speed of processing (p= 0.031, 95% Confidence Interval CI [-90.36 to -29.64], large effect size Φ = 0.7) and sustained attention (digit span - time, (p= 0.015, 95% CI [-99.40 to -41.60], large effect size Φ = 0.7)). The outcome of this study shows that the computerized cognitive training is feasible and useful in treating cognitive deficits in Indian patients with schizophrenia.

The role of cognitive group therapy and happiness training on cerebral blood flow using 99mTc-ECD brain perfusion SPECT

2014 ◽  
Vol 53 (05) ◽  
pp. 205-210
Author(s):  
M. Azizi ◽  
S. A. Bahrieniain ◽  
A. Baghdasarians ◽  
S. Emamipur ◽  
Z. Azizmohammadi ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Group Therapy ◽  
Brain Perfusion ◽  
Control Group ◽  
Brain Perfusion Spect ◽  
Significant Difference ◽  
Before And After ◽  
Perfusion Spect ◽  
The Impact

Summary Objective: The purpose of this study is to investigate the impact of cognitive group therapy and happiness training objectively in the local cerebral blood flow of patients with major depression (MD). Patients, material, methods: The present research is semi-experimental to pre- and post-test with a control group. Three groups were formed, and this number was incorporated in each group: 12 patients were chosen randomly; the first group of depressed patients benefited from the combination of pharmacotherapy and sessions of cognitive group therapy; the second group used a combination of pharmaco- therapy and sessions of happiness training; and a third group used only pharmacother- apy. We compared cognitive-behavioural therapy and happiness training efficacy with only pharmacotherapy in MD patients. We performed brain perfusion SPECT in each group, before and after each trial. Results: The study was conducted on 36 patients with MD (32 women and 4 men; mean age: 41.22 ± 9.08; range: 27-65 years). There were significant differences regarding the two trial effects into two experimental groups (p < 0/001) before and after trials, while such differences were not significant in the control group (p > 0.05). In addition, there was significant difference among the regional cerebral blood flow in the frontal and prefrontal regions into two experimental groups before and after trials (p < 0/001), while such differences were not significant in the control group (p > 0.05). Conclusion: This study demonstrated decreased cerebral perfusion in the frontal regions in MD patients, which increased following cognitive group therapy and happiness training. Because of its availability, low costs, easy performance, and the objective semi-quantitative information supplied, brain perfusion SPECT

scholarly journals Effects of cognitive remediation on negative symptoms dimensions: exploring the role of working memory

2017 ◽  
Vol 47 (15) ◽  
pp. 2593-2601 ◽  
Author(s):  
M. Cella ◽  
D. Stahl ◽  
S. Morris ◽  
R. S. E. Keefe ◽  
M. D. Bell ◽  
...  
Keyword(s):  
Working Memory ◽  
Negative Symptoms ◽  
Digit Span ◽  
Statistical Significance ◽  
Cognitive Remediation ◽  
Cognitive Domain ◽  
Symptom Improvement ◽  
Syndrome Scale ◽  
Before And After

BackgroundRecent theories suggest that poor working memory (WM) may be the cognitive underpinning of negative symptoms in people with schizophrenia. In this study, we first explore the effect of cognitive remediation (CR) on two clusters of negative symptoms (i.e. expressive and social amotivation), and then assess the relevance of WM gains as a possible mediator of symptom improvement.MethodData were accessed for 309 people with schizophrenia from the NIMH Database of Cognitive Training and Remediation Studies and a separate study. Approximately half the participants received CR and the rest were allocated to a control condition. All participants were assessed before and after therapy and at follow-up. Expressive negative symptoms and social amotivation symptoms scores were calculated from the Positive and Negative Syndrome Scale. WM was assessed with digit span and letter-number span tests.ResultsParticipants who received CR had a significant improvement in WM scores (d = 0.27) compared with those in the control condition. Improvements in social amotivation levels approached statistical significance (d = −0.19), but change in expressive negative symptoms did not differ between groups. WM change did not mediate the effect of CR on social amotivation.ConclusionsThe results suggest that a course of CR may benefit behavioural negative symptoms. Despite hypotheses linking memory problems with negative symptoms, the current findings do not support the role of this cognitive domain as a significant mediator. The results indicate that WM improves independently from negative symptoms reduction.

EVALUATION OF INTERVENTIONS BASED ON DEPRESSION SIGN SCORES OF ADOLESCENTS

2008 ◽  
Vol 36 (1) ◽  
pp. 123-134 ◽  
Author(s):  
Zuhal Bahar ◽  
Meryem ÖZtürk ◽  
Ayşe Beşer ◽  
Ayşen Baykara ◽  
Gülşen Eker ◽  
...  
Keyword(s):  
Group Therapy ◽  
Occupational Therapy ◽  
Therapy Group ◽  
Turkish Version ◽  
Significant Difference ◽  
Before And After ◽  
Group A ◽  
Group B ◽  
Marmara Earthquake ◽  
To Receive

The aim in this study was to compare effects of problem-based group therapy and occupational therapy on depression scores six months after the Marmara earthquake in Golcuk. The study included 187 seventh grade students. Data were collected with the Children's Depression Inventory (CDI; Kovacs, 1981, Turkish version by Öy, 1991) and a sociodemographic form. The schools were randomly assigned into two groups, either to receive problem-based group therapy (Group A) or occupational therapy (Group B). CDI was administered before and after the therapies and depression sign scores were recorded. After the first and second sessions of the therapies, there was no significant difference in mean depression scores between both groups, but there was a significant decrease in CDI scores of the adolescents.

scholarly journals Efficacy of psychological treatments for patients with schizophrenia and relevant negative symptoms: A meta-analysis

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Marcel Riehle ◽  
Mara Cristine Böhl ◽  
Matthias Pillny ◽  
Tania Marie Lincoln
Keyword(s):  
Negative Symptoms ◽  
Primary Outcome ◽  
Behavioral Therapy ◽  
Meta Analysis ◽  
Cognitive Remediation ◽  
Target Population ◽  
Therapeutic Approaches ◽  
Treatment As Usual ◽  
Psychological Treatments ◽  
Meta Analyses

Background Recent meta-analyses on the efficacy of psychological treatments for the negative symptoms of schizophrenia included mostly trials that had not specifically targeted negative symptoms. To gauge the efficacy of such treatments in the target patient population – namely people with schizophrenia who experience negative symptoms – we conducted a meta-analysis of controlled trials that had established an inclusion criterion for relevant negative symptom severity. Method We conducted a systematic literature search and calculated random-effects meta-analyses for controlled post-treatment effects and for pre-post changes within treatment arms. Separate analyses were conducted for different therapeutic approaches. Our primary outcome was reduction in negative symptoms; secondary outcomes were amotivation, reduced expression, and functioning. Results Twelve studies matched our inclusion criteria, testing Cognitive Behavioral Therapy (CBT) vs. treatment-as-usual (k = 6), Cognitive Remediation (CR) vs. treatment-as-usual (k = 2), CBT vs. CR (k = 2), and Body-oriented Psychotherapy (BPT) vs. supportive group counseling and vs. Pilates (k = 1 each). Accordingly, meta-analyses were performed for CBT vs. treatment-as-usual, CR vs. treatment-as-usual, and CBT vs. CR. CBT and CR both outperformed treatment-as-usual in reducing negative symptoms (CBT: Hedges’ g = -0.46; CR: g = -0.59). There was no difference between CBT and CR (g = 0.12). Significant pre-post changes were found for CBT, CR, and to a lesser extent for treatment-as-usual, but not for BPT. Conclusion Although effects for some approaches are promising, more high-quality trials testing psychological treatments for negative symptoms in their target population are needed to place treatment recommendations on a sufficiently firm foundation.

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