title: An alternative to generating alternative interpretations in social cognitive therapy for psychosis.
abstract: BACKGROUND
  Generating alternative interpretations is a widely used technique in cognitively-oriented treatments for psychosis, including social cognitive treatments. However, research on judgment and decision-making suggests that this technique may backfire among individuals with cognitive deficits.
  
  
  OBJECTIVE
  Mary/Eddie/Bill (MEB) was developed as an alternative approach to help improve Theory of Mind, attributional bias and Jumping to Conclusions in psychosis. An initial pilot trial was conducted to evaluate the tolerability and potential efficacy of MEB.
  
  
  METHODS
  Twenty-four outpatients with psychotic disorders participated in an uncontrolled trial. Social cognition, social functioning, and participant feedback were assessed.
  
  
  RESULTS
  Treatment completers exhibited statistically significant improvements in Theory of Mind, social cognitive overconfidence and self-reported social engagement, and reported positive experiences with MEB. No improvements were observed in attributional bias.
  
  
  CONCLUSIONS
  Given that there are risks associated with the use of traditional generating-alternatives techniques, the current findings support ongoing development of MEB and similar approaches.
authors.affiliation: University of Texas Health Science Center, San Antonio, TX 78229, USA. robertsd5@uthscsa.edu
authors.forename: David L
authors.initials: DL
authors.lastname: Roberts
authors.forename: Petra
authors.initials: P
authors.lastname: Kleinlein
authors.forename: Bruce
authors.initials: B
authors.lastname: Stevens
mesh_terms: D000328:Adult; D001364:Awareness; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D006801:Humans; D007389:Internal-External Control; D007398:Interpersonal Relations; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy*; D012559:Schizophrenia / Q000175:diagnosis / Q000628:therapy*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D056345:Theory of Mind; D016896:Treatment Outcome