Psychosocial treatments for schizophrenia.
ABSTRACT As indicated in recent treatment guidelines, psychosocial treatments play a critical role in the rehabilitation of schizophrenia patients. During the past few years, novel psychosocial treatments have emerged expanding the scope of successful outcomes and designed to address the specific deficits inherent in schizophrenia. This paper provides a brief description and evaluate the efficacy of five new emerging psychosocial treatments for schizophrenia. There is strong evidence for the efficacy of supported employment programs and family therapy, especially those involving multiple family interactions. Although schizophrenia patients appear to derive benefit from cognitive behavioral therapy, no evidence supports it superiority over that of other individual psychotherapies. The trials of cognitive remediation to date have been largely unsuccessful, although new innovative approaches continue to be tested. Finally, substance use treatment specifically designed to address the deficits in schizophrenia patients have been formulated, which are supported by optimistic pilot data and awaiting the completion of on-going clinical trials.
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ABSTRACT: The Schizophrenia Patient Outcomes Research Team and others have previously included family psychoeducation and family support in best practices guidelines and treatment recommendations for persons with schizophrenia. In this article we review in detail 15 new studies on family interventions to consider issues around the implementation of family interventions in current practice. The data supporting the efficacy of family psychoeducation remain compelling. Such programs should remain as part of best practices guidelines and treatment recommendations. However, assessment of the appropriateness of family psychoeducation for a particular patient and family should consider (1) the interest of the family and patient; (2) the extent and quality of family and patient involvement; (3) the presence of patient outcomes that clinicians, family members, and patients can identify as goals; and (4) whether the patient and family would choose family psychoeducation instead of alternatives available in the agency to achieve outcomes identified.Schizophrenia Bulletin 02/2000; 26(1):5-20. · 8.49 Impact Factor
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ABSTRACT: This article presents research-based principles of vocational rehabilitation that have emerged from the study of diagnostically heterogeneous populations of persons with severe mental illness. Employment and vocational functioning outcomes of people with schizophrenia from recently published followup studies are described. In addition, we present research conducted over the past decade concerning differential outcomes of vocational rehabilitation services for people with schizophrenia versus other psychotic and nonpsychotic disorders. We then explore studies of people with schizophrenia that may illuminate the links between specific features of this disorder--including symptomatology, social skills, and neuropsychological impairments--and poorer vocational outcome. We conclude with a set of recommendations for clinical practice that draw upon the most recent discoveries and insights in this field.Schizophrenia Bulletin 02/2000; 26(1):87-103. · 8.49 Impact Factor
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ABSTRACT: Recent research elucidates many aspects of the problem of co-occurring substance use disorder (SUD) in patients with severe mental illness, which is often termed dual diagnosis. This paper provides a brief overview of current research on the epidemiology, adverse consequences, and phenomenology of dual diagnosis, followed by a more extensive review of current approaches to services, assessment, and treatment. Accumulating evidence shows that comorbid SUD is quite common among individuals with severe mental illness and that these individuals suffer serious adverse consequences of SUD. The research further suggests that traditional, separate services for individuals with dual disorders are ineffective, and that integrated treatment programs, which combine mental health and substance abuse interventions, offer more promise. In addition to a comprehensive integration of services, successful programs include assessment, assertive case management, motivational interventions for patients who do not recognize the need for substance abuse treatment, behavioral interventions for those who are trying to attain or maintain abstinence, family interventions, housing, rehabilitation, and psychopharmacology. Further research is needed on the organization and financing of dual-diagnosis services and on specific components of the integrated treatment model, such as group treatments, family interventions, and housing approaches.Schizophrenia Bulletin 02/2000; 26(1):105-18. · 8.49 Impact Factor