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Am J Psychiatry 1996; 153:607-617
Copyright © 1996 by American Psychiatric Association
Research update on the psychosocial treatment of schizophrenia
DL Penn and KT Mueser
Department of Psychology, Illinois Institute of Technology, Chicago 60616-3793, USA.
OBJECTIVE: This review is an update on the research evidence supporting
psychosocial treatment for schizophrenia. It extends previous review
articles by summarizing the literature on social skills training, family
interventions, cognitive rehabilitation, and coping with residual positive
symptoms. METHOD: The authors reviewed controlled treatment outcome studies
of social skills training and family interventions. Different models of
family therapy were contrasted. The current literature on cognitive
rehabilitation and coping with residual positive symptoms was also
examined. RESULTS: Social skills training produces improvement on specific
behavioral measures, although changes in symptoms and community functioning
are less pronounced. Family interventions (i.e., family psychoeducation and
behavioral family therapy) are highly effective for reducing families'
expressed emotion and improving patients' relapse rates and outcomes.
Furthermore, family interventions are also associated with reduced family
burden. Cognitive rehabilitation and training in coping with positive
symptoms appear to be promising interventions, but more controlled, group
trials are needed before definite conclusions can be drawn. CONCLUSIONS:
The efficacy of a variety of different family intervention models, as well
as social skills training, is supported by a large body of research. Future
work needs to address improving delivery of existing psychosocial
interventions, integrating these interventions with other psychosocial
approaches (e.g., vocational rehabilitation and case management),
identifying which patients will benefit from which treatments, isolating
the "active" ingredients of family interventions (i.e., psychoeducation
versus behavioral intervention), and identifying the amount of treatment
(e.g., number of sessions) needed before treatment response is expected.
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