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Psychosocial skills training in schizophrenia: Process, outcome, and key influences
The efficacy of psychosocial skills training for individuals with serious mental illness has been well-documented. However, several questions remain regarding the course of, individual variability in response to, and predictors of response to skills training. The present study investigated course patterns during psychosocial skills training in individuals with serious mental illness. Five hypotheses were tested related to (a) the course of treatment progress during skills training, (b) relations between treatment progress and microprocess variables (e.g., attention), (c) identification of patient subgroups with varying amounts and rates of progress, (d) characterization of patient subgroups using pretreatment neurocognitive and social cognitive variables, and (e) examination of outcomes associated with subgroup membership. Archival clinical data from 93 individuals with serious mental illness at an inpatient psychiatric rehabilitation program in Nebraska was used. These individuals participated in a 9-week Medication Management skills training module developed at the University of California, Los Angeles. Results indicated that on average, participants improved over the course of skills training as assessed by a trainer-rated measure of treatment progress. There was significant inter-individual variation in progress ratings during the first week and over the course of skills training. Regarding relations with microprocess variables, treatment progress was strongly influenced by facilitating variables (attention, participation, and spontaneity). In contrast, hindering variables (withdrawal, disruption, and bizarre behavior) minimally impacted treatment progress. Three distinct treatment progress trajectories emerged: a low progress class ( n = 10), a moderate progress class (n = 61), and a high progress class (n = 22). Low progress class members differed from other class members in having poorer neurocognitive functioning at admission. The groups did not differ in social cognitive functioning at admission. Finally, the three classes differed in their likelihood of completing skills training and in post-treatment psychosocial functioning. Findings suggest that there is significant heterogeneity in the rate and magnitude of change during skills training. Psychosocial skills training programs should consider this heterogeneity and tailor interventions to particular patient subpopulations for optimal effectiveness. ^
Iyer, Srividya N, "Psychosocial skills training in schizophrenia: Process, outcome, and key influences" (2006). ETD collection for University of Nebraska - Lincoln. AAI3217589.