Randomized controlled trial of cognitive behavioral social skills training for older people with schizophrenia: 12-month follow-up.
OBJECTIVE
There is an increasing need for empirically validated psychotherapy interventions that improve functioning in older people with schizophrenia. We developed a 24-session weekly group therapy intervention labeled Cognitive Behavioral Social Skills Training (CBSST), which combined cognitive-behavioral therapy with social skills and problem-solving training to improve functioning.


METHODS
We previously reported end-of-treatment findings from a randomized controlled trial that compared treatment as usual (TAU) with TAU plus group CBSST in 76 outpatients, 42 to 74 years of age, with schizophrenia or schizoaffective disorder (DSM-IV criteria). Twelve-month follow-up results of that trial (conducted from October 1999 to September 2004) are reported here. Blind raters obtained assessments of CBSST skill mastery, functioning, psychotic and depressive symptoms, and cognitive insight (belief flexibility).


RESULTS
The significantly greater skill acquisition and self-reported performance of living skills in the community seen in CBSST versus TAU patients at the end of treatment were maintained at 12-month follow-up (p < or = .05). Participants in CBSST also showed significantly greater cognitive insight at the end of treatment relative to TAU, but this improvement was not maintained at follow-up. The treatment-group effect was not significant for symptoms at any assessment point; however, symptoms were not the primary treatment target in this stable outpatient sample.


CONCLUSIONS
Older people with very chronic schizophrenia were able to learn and maintain new skills with CBSST and showed improved self-reported functioning 1 year after the treatment ended. Longer treatment and/or booster sessions may be required to maintain gains in cognitive insight.
Granholm
Eric
E
Veterans Affairs San Diego Healthcare System, San Diego, Calif 92161, USA. e.granholm@ucsd.edu
McQuaid
John R
JR
McClure
Fauzia Simjee
FS
Link
Peter C
PC
Perivoliotis
Dimitri
D
Gottlieb
Jennifer D
JD
Patterson
Thomas L
TL
Jeste
Dilip V
DV
D000328:Adult; D000367:Age Factors; D000368:Aged; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D011615:Psychotherapy, Group; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D016037:Single-Blind Method; D012919:Social Behavior; D016896:Treatment Outcome