Cognitive-behavioral therapy for schizophrenia: A review
This article describes the role that cognitive behavioral therapy has as an adjunct antipsychotic medication and remediative approaches such as social skills training in the management of residual symptoms of chronic schizophrenia. The article mentions that CBT can be combined with family therapy and assertive community treatment programs to reduce relapse and that ACT could complement the delivery of individual CBT.
Keywords: atypical antipsychotics cognitive remediation family interventions negative symptoms positive symptoms psychoeducation psychotherapy residual symptoms schizophrenia social skills training cognitive-behavioural therapy (cbt) module 4
Turkington, D., Dudley, R., Warman, D.M., & Beck, A.T. (2004). Cognitive-behavioral therapy for schizophrenia: A review. Journal of Psychiatric Practice, 10 (1), 5-16.
Psychosocial treatments for schizophrenia
This book chapter provides an overview of schizophrenia and the status of psychosocial treatments for schizophrenia (i.e., therapeutic relationship and supportive therapy; behavior therapy and social learning programs; cognitive behavioral therapy; structured, educational family interventions; vocational rehabilitation; case management and treatment teams). The author includes additional considerations for those with a dual diagnosis (substance use and mental disorders) as well as future directions of other treatments such as cognitive rehabilitation. The authors summarize that multiple psychosocial treatment modalities must be delivered to patients if their multidimensional needs are to be met. They conclude that these treatments are most efficacious when delivered in a continuous, comprehensive, and well-coordinated manner within a service such as assertive community treatment.
Keywords: behavior modification behavior therapy and social learning programs behavioral treatments family interventions psychological treatment psychosocial treatments psychotherapy psychsocial treatments including supportive therapy schizophrenia skills training supported employment token economy vocational rehab cognitive-behavioural therapy (cbt) module 1 module 4
Kopelowicz, A., Liberman, R.P., & Zarate, R. (2007). Psychosocial treatments for schizophrenia. In Nathan, P. E., & Gorman, J. M. A guide to treatments that work (pp.243-269). Oxford University Press, USA.
The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements.
The Schizophrenia Patient Outcomes Research Team (PORT) psychosocial treatment recommendations provide a comprehensive summary of current evidence-based psychosocial treatment interventions for persons with schizophrenia. This article reports the third set of PORT recommendations that includes updated reviews in 7 areas as well as adding 5 new areas of review. Members of the psychosocial Evidence Review Group conducted reviews of the literature in each intervention area and drafted the recommendation or summary statement with supporting discussion. A Psychosocial Advisory Committee was consulted in all aspects of the review, and an expert panel commented on draft recommendations and summary statements. The review process produced 8 treatment recommendations in the following areas: assertive community treatment, supported employment, cognitive behavioral therapy, family-based services, token economy, skills training, psychosocial interventions for alcohol and substance use disorders, and psychosocial interventions for weight management. Reviews of treatments focused on medication adherence, cognitive remediation, psychosocial treatments for recent onset schizophrenia, and peer support and peer delivered services indicated that none of these treatment areas yet have enough evidence to merit a treatment recommendation, though each is an emerging area of interest. This update of PORT psychosocial treatment recommendations underscores both the expansion of knowledge regarding psychosocial treatments for persons with schizophrenia at the same time as the limitations in their implementation in clinical practice settings.
Keywords: psychotherapy family-based services schizophrenia psychosocial treatment cognitive-behavioural therapy (cbt) module 1 module 4
Dixon, L. B., Dickerson, F., Bellack, A. S., Bennett, M., Dickinson, D., Goldberg, R. W.,...& Kreyenbuhl, J. (2010). The 2009 schizophrenia PORT psychosocial treatment recommendations and summary statements.Schizophrenia Bulletin, 36(1), 48-70. doi:10.1093/schbul/sbp115
Psychotherapy for schizophrenia in an ACT team context
This case study discusses the treatment of a man diagnosed with schizophrenia with severe social anxiety. CBT approaches were used and treatment was conducted by a psychotherapist within the context of ACT services. CBT and ACT were found to be complementary, and the combination of approaches was found to be effective helping to reduce the client’s social anxiety. However, the client decided after all that he did not want to continue therapy. The authors recommend that clinicians working within ACT teams attempt to incorporate CBT approaches to better address the needs of their clients.
Smith, S.M., & Yanos, P.T. (2009). Psychotherapy for schizophrenia in an ACT team context. Clinical Case Studies, 8(6), 454-462. doi: 10.1177/1534650109352006
Treating comorbid substance use disorders in schizophrenia
This literature review examines the pharmacological and psychosocial treatment approaches for people with schizophrenia and comorbid substance use disorder(s) (SUD). The results show that despite the high prevalence of comorbid SUD among people with schizophrenia, there is a considerable shortage of rigorously conducted randomized controlled treatment trials. Although there is some evidence for clozapine, and for the adjunctive use of agents such as naltrexone for comorbid alcohol dependence, the available literature largely comprises case studies, case series, open label studies and retrospective surveys. In terms of psychosocial approaches, there is reasonable consensus that integrated approaches are most appropriate. Regarding specific aspects of care, motivational interviewing, cognitive behavioral therapy, contingency management, and family interventions have an emerging supportive literature. The authors state there is no ‘one size fits all’, and a flexible approach with the ability to apply specific components of care to particular individuals, is required. Group-based therapies and longer-term residential services have an important role for some patients, but further research is required to delineate more clearly which patients will benefit from these strategies. The authors conclude that although there is growing evidence that integrated and well articulated interventions that encompass pharmacological and psychosocial parameters can be beneficial for people with schizophrenia and comorbid SUD, there remains a considerable gap in the literature available to inform evidence-based practice
Keywords: psychotherapy treating co-morbid substance use in schizophrenia pharmacotherapy psychological treatment schizophrenia alcohol cannabis cocaine heroin module 1 module 4
Lubman, D. I., King, J. A., & Castle, D. J. (2010). Treating comorbid substance use disorders in schizophrenia. International Review of psychiatry, 22(2), 191-201.
Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials.
This meta-analytical review of the CBT for major psychiatric disorders states that although cognitive behavioural therapy (CBT) is claimed to be effective in schizophrenia, major depression and bipolar disorder, there have been negative findings in well-conducted studies and meta-analyses have not fully considered the potential influence of blindness or the use of control interventions. In the current meta-analysis it found that CBT is no better than non-specific control interventions in the treatment of schizophrenia and does not reduce relapse rates.
Keywords: psychotherapy bipolar disorder cognitive therapy depression schizophrenia cognitive-behavioural therapy (cbt) module 4
Lynch, D., Laws, K. R., & McKenna, P. J. (2010). Cognitive behavioural therapy for major psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials. Psychological medicine, 40(01), 9-24. doi:10.1017/S003329170900590X