Article

Skill Building: Assessing the Evidence

Psychiatric services (Washington, D.C.) (Impact Factor: 2.41). 04/2014; 65(6). DOI: 10.1176/appi.ps.201300251
Source: PubMed

ABSTRACT

Objective:
Skill building for adults involves multiple approaches to address the complex problems related to serious mental illness. Individuals with schizophrenia are often the research focus. The authors outline key skill-building approaches and describe their evidence base.

Methods:
Authors searched meta-analyses, research reviews, and individual studies from 1995 through March 2013. Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, Published International Literature on Traumatic Stress, ERIC, and CINAHL. Authors chose from three levels of evidence (high, moderate, and low) on the basis of benchmarks for the number of studies and quality of their methodology. They also described the evidence of service effectiveness.

Results:
Over 100 randomized controlled trials and numerous quasi-experimental studies support rating the level of evidence as high. Outcomes indicate strong effectiveness for social skills training, social cognitive training, and cognitive remediation, especially if these interventions are delivered through integrated approaches, such as Integrated Psychological Therapy. Results are somewhat mixed for life skills training (when studied alone) and cognitive-behavioral approaches. The complexities of schizophrenia and other serious mental illnesses call for individually tailored, multimodal skill-building approaches in combination with other treatments.

Conclusions:
Skill building should be a foundation for rehabilitation services covered by comprehensive benefit plans that attend to the need for service packages with multiple components delivered in various combinations. Further research should demonstrate more conclusively the long-term effectiveness of skill building in real-life situations, alone and in various treatment combinations. Studies of diverse subpopulations are also needed.

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Available from: Marianne Farkas, Sep 22, 2015
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    • "Current, continuous, and cumulative trauma-focused cognitive behavior therapy (CCC-TF-CBT), (Kira, 2013; Kira, Ashby, Omidy, & Lewandowski, in press), a part of this packaged model, include four core components (behavioral, pre-cognitive, cognitive, and social), with eight intervention modes: Two behavioral interventions modes: 1) prioritizing safety, and addressing current and ongoing threats and dangers: distinguishing real danger from exaggerated, down played (avoided) and the real challenges (e.g, Najavits, 2002; Murray, Cohen, & Mannarino , 2013); 2) practicing basic skills training to deal with real threats and dangers (e.g. problem solving, assertiveness training, mindfulness training, anger management, personal and group-based emotion regulation, and enhancing participation and engagement) (e.g., Lyman et al., 2014; Liu, Huang, & Wang, 2014); two pre-cognitive intervention modes; 3) stimulating " will to live and survive and related meaningful effective coping strategies (e.g., Bonanno & Mancini, 2008, Kira, Alawneh, Aboumediene, Lewandowski, & Laddis, 2014); and 4) identity work, identities reconfiguration, and identity development that may include: redefinition of identities (e.g., gender sexual, racial, religious, national, species in addition to; personal and collective self-esteem and self-efficacy) (e.g., Scheepers, Spears, Manstead, & Doosje, 2009; Gaertner & Dovidio, 2005) and three cognitive intervention modes; 5) psycho-education of continuous traumatic stress and cumulative and proliferation and stress generation dynamics (e.g., Kira et al., 2013; Kira et al., 2014); 6) inoculation against stress proliferation and accumulation dynamics and training to identify and disrupt such existing dynamics; and 7) narration and writing intervention and one social intervention modes (e.g., Travagina, Margolaa, & Revensonb, 2015); 8) reconnection, advocacy and social Justice using Scientist-Practitioner-Advocate (SPA) model (Mallinckrodt, Miles, & Levy, 2014). Diagram 1 visualizes this model. "

    Full-text · Article · Jan 2015 · Psychology
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    • "Current, continuous, and cumulative trauma-focused cognitive behavior therapy (CCC-TF-CBT), (Kira, 2013; Kira, Ashby, Omidy, & Lewandowski, in press), a part of this packaged model, include four core components (behavioral, pre-cognitive, cognitive, and social), with eight intervention modes: Two behavioral interventions modes: 1) prioritizing safety, and addressing current and ongoing threats and dangers: distinguishing real danger from exaggerated, down played (avoided) and the real challenges (e.g, Najavits, 2002; Murray, Cohen, & Mannarino , 2013); 2) practicing basic skills training to deal with real threats and dangers (e.g. problem solving, assertiveness training, mindfulness training, anger management, personal and group-based emotion regulation, and enhancing participation and engagement) (e.g., Lyman et al., 2014; Liu, Huang, & Wang, 2014); two pre-cognitive intervention modes; 3) stimulating " will to live and survive and related meaningful effective coping strategies (e.g., Bonanno & Mancini, 2008, Kira, Alawneh, Aboumediene, Lewandowski, & Laddis, 2014); and 4) identity work, identities reconfiguration, and identity development that may include: redefinition of identities (e.g., gender sexual, racial, religious, national, species in addition to; personal and collective self-esteem and self-efficacy) (e.g., Scheepers, Spears, Manstead, & Doosje, 2009; Gaertner & Dovidio, 2005) and three cognitive intervention modes; 5) psycho-education of continuous traumatic stress and cumulative and proliferation and stress generation dynamics (e.g., Kira et al., 2013; Kira et al., 2014); 6) inoculation against stress proliferation and accumulation dynamics and training to identify and disrupt such existing dynamics; and 7) narration and writing intervention and one social intervention modes (e.g., Travagina, Margolaa, & Revensonb, 2015); 8) reconnection, advocacy and social Justice using Scientist-Practitioner-Advocate (SPA) model (Mallinckrodt, Miles, & Levy, 2014). Diagram 1 visualizes this model. "
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