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Social Skills Training for Schizophrenia

The following treatment guidelines are meant as a reference tool only, and are not intended as treatment advice or to replace the clinical decision-making process of psychiatrists or other health professionals who administer these treatments. In clinical practice there are often good reasons why treatment approaches differ from what is described here.

 

Negative symptoms and cognitive deficits cause the greatest amount of disability to people with Schizophrenia, and one of the principle ways in which this manifests is in problems with basic social skills, such as being emotionally attentive towards others, maintaining proper manners and social graces, picking-up on other people's social cues, and presenting oneself in a proper and decent manner in public.  Without these basic social skills, people with Schizophrenia tend to become marginalized in society, and this can lead to isolation and a significantly decreased quality of life.

Social skills training programs are designed to re-teach people with Schizophrenia these basic skills that they have lost due to their illness.  The goals of these programs are to improve the person's ability to find fulfilling jobs, maintain relationships, manage their basic activities of daily living, and ultimately improve the person's overall psychological wellbeing.

There are different types of social skills training programs that have been developed.  The basic model uses role-playing techniques to teach various verbal and nonverbal aspects of social behavior.   The UCLA model is a social problem-solving model. It targets specific domains such as medication and symptoms management, recreation, basic conversation, money management, domestic skills and self-care skills, and helps the person to develop strategies to manage these tasks.  The cognitive remediation model attempts to correct some of the cognitive deficits in Schizophrenia, such as problems with attention and planning.

Of these different approaches, only the UCLA model has shown any clear beneficial results; it improves client's social adjustments in their communities, an effect which seems to last for at least 2 years after the treatment [ref].  However, it has not been shown to improve other clinical parameters.   The cognitive remediation model lacks evidence for any clear benefits [ref].  

 

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