The effectiveness of a combination of Occupational Therapy and Social Skills Training in people with schizophrenia: A rater-blinded randomized controlled trial

Introduction This study aimed to assess the impact of a holistic combination of Occupational Therapy and Social Skills Training on occupational performance, social participation, and clinical symptoms in people with schizophrenia. Method 60 people with schizophrenia were randomly assigned to two groups. One group received standardized Social Skills Training once a week for a total of 10 sessions, while the other group received a combination of Occupational Therapy and Social Skills Training once a week for a total of 16 sessions. Results A greater increase was determined in the scores of COPM total performance/satisfaction and the Community Integration Questionnaire in the Occupational Therapy and Social Skills Training group. Furthermore, these achievements were sustained in the Occupational Therapy and Social Skills Training group compared to the Social Skills Training group at the 6-month follow-up. Conclusion The clients received the combination of Occupational Therapy and Social Skills Training showed a better improvement compared to the Social Skills Training group in terms of occupational performance, social participation, and severity of clinical symptoms. The use of Occupational Therapy in a holistic approach in psychosocial rehabilitation of people with schizophrenia can increase their functionality and social participation. Further studies are needed to assess long-term effects of Occupational Therapy in schizophrenia.

Evaluation of a structured skills training group for adolescents with attention-deficit/hyperactivity disorder: a randomised controlled trial

Attention-deficit/hyperactivity disorder (ADHD) in adolescence is associated with behavioural, emotional and interpersonal problems, and non-pharmacological treatments targeting these difficulties have been requested. The objective of this study was to evaluate the effectiveness and acceptance of an age-adapted structured skills training group (SSTG) for adolescents with ADHD. Adolescents (n = 184, ages 15–18 years) with a diagnosis of ADHD were randomly assigned to either the SSTG, which is based on dialectical behavioural therapy, or an active control group based on psychoeducation. Symptoms of ADHD, behavioural and emotional problems, functional impairment, and health-related outcomes were assessed with self-ratings and parental ratings two weeks before, two weeks after, and six months after treatment. All participants who completed the pre-treatment measurements (n = 164) were included in the main analyses, which were conducted using a linear mixed model. Our results demonstrated no significant group differences in favour of the SSTG for any of the study outcomes. A majority of the participants in both groups reported that they had increased their knowledge about ADHD, improved their ability to manage problems related to the diagnosis, and would recommend the treatment to others. We conclude that the SSTG seems to be acceptable for adolescents with ADHD in a clinical context. However, the treatment was not proved to be more effective or more acceptable than the psychoeducational control intervention.Trial registration: http://www.isrctn.com/ISRCTN17366720,11/05/2016, retrospectively registered.

Practicing Procedural Skills Is More Effective Than Basic Psychomotor Training in Knee Arthroscopy: A Randomized Study

Background: Simulator-assisted arthroscopy education traditionally consists of initial training of basic psychomotor skills before advancing to more complex procedural tasks. Purpose: To explore and compare the effects of basic psychomotor skills training versus procedural skills training on novice surgeons’ subsequent simulated knee arthroscopy performance. Study Design: Controlled laboratory study. Methods: Overall, 22 novice orthopaedic surgeons and 11 experienced arthroscopic surgeons participated in this study, conducted from September 2015 to January 2017. Novices received a standardized introductory lesson on knee arthroscopy before being randomized into a basic skills training group or a procedural skills training group. Each group performed 2 sessions on a computer-assisted knee arthroscopy simulator: The basic skills training group completed 1 session consisting of basic psychomotor skills modules and 1 session of procedural modules (diagnostic knee arthroscopy and meniscal resection), whereas the procedural skills training group completed 2 sessions of procedural modules. Performance of the novices was compared with that of the experienced surgeons to explore evidence of validity for the basic psychomotor training skills modules and the procedural modules. The effect of prior basic psychomotor skills training and procedural skills training was explored by comparing pre- and posttraining performances of the randomized groups using a mixed-effects regression model. Results: Validity evidence was found for the procedural modules, as test results were reliable and experienced surgeons significantly outperformed novices. We found no evidence of validity for the basic psychomotor skills modules, as test scores were unreliable and there was no difference in performance between the experienced surgeons and novices. We found no statistical effect of basic psychomotor skills training as compared with no training ( P = .49). We found a statistically significant effect of prior procedural skills training ( P < .001) and a significantly larger effect of procedural skills training as compared with basic psychomotor skills training ( P = .019). Conclusion: Procedural skills training was significantly more effective than basic psychomotor skills training regarding improved performance in diagnostic knee arthroscopy and meniscal resection on a knee arthroscopy simulator. Furthermore, the basic psychomotor skills modules lacked validity evidence. Clinical Relevance: On the basis of these results, we suggest that future competency-based curricula focus their training on full knee arthroscopy procedures. This could improve future education programs.

Preventive Treatment on Sexual Abuse Survivor with Mental Retardation

The existence of limitations for children with mental retardation causes an inability toprotect themselves so that they often become victims of sexual harassment. Preventiveefforts are something that needs to be improved for prevention, considering the worse risksto children. The importance of an effort to prevent sexual abuse of children with mentalretardation in connection with the lack of knowledge about sexual abuse and the inability ofchildren to face the dangers that threaten themselves. From the results of researchconducted in the United States in 1994, nearly 90% of children with mental retardationdisorders had experienced sexual abuse, as many as 49% had experienced sexual abusemore than ten times. The high incidence of sexual abuse experienced by children with mentalretardation is due to various factors, namely the condition of children's limitations, lack ofsupervision and protection of children by parents and the environment. Efforts that can bemade are increasing knowledge about sexual abuse and self-protection skills through theBehavioral Skills Training Group Program, where children are trained to recognizethreatening objects and situations (sexual abuse). Increasing knowledge about sexual abuseand providing training (self-protection skills) is a significant primary preventive measure toreduce the risk of sexual abuse in children with mental retardation.

Multilevel Associations of Daily Skill Use and Effectiveness With Anxiety, Stress, and Depression in a Transdiagnostic Sample Undergoing Dialectical Behavior Therapy Skills Training

Dialectical Behavior Therapy (DBT) is relatively effective at treating disorders of emotion dysregulation. However, given researchers’ focus on group-level differences within disorder-specific treatments, it is unclear which transdiagnostic mechanisms influence these effects. Participants (n=19, Mage=31.8, 68% female, 95% Caucasian) with elevated emotion dysregulation completed daily reports of DBT skill use, perceived effectiveness, anxiety, stress, and depression during a DBT skills training group (1,344 observations). We tested whether within-person skill use was associated with same-day negative affect, predicted next-day changes in negative affect, and was moderated by perceived emotion regulation effectiveness. Participants used more within-person skills on days of greater stress and anxiety, which predicted next-day decreases in stress and anxiety. On days of high, but not low, perceived effectiveness, people used more skills in response to more intense negative affect. The use, and perceived effectiveness, of more skills may be mechanisms by which DBT skills groups promote improved emotional functioning.