Objective: Identifying treatments to improve functioning and reduce negative symptoms in consumers with schizophrenia is of high public health significance. Method: In this randomized clinical trial, ...participants with schizophrenia or schizoaffective disorder (N = 149) were randomly assigned to cognitive behavioral social skills training (CBSST) or an active goal-focused supportive contact (GFSC) control condition. CBSST combined cognitive behavior therapy with social skills training and problem-solving training to improve functioning and negative symptoms. GFSC was weekly supportive group therapy focused on setting and achieving functioning goals. Blind raters assessed functioning (primary outcome: Independent Living Skills Survey ILSS), CBSST skill knowledge, positive and negative symptoms, depression, and defeatist performance attitudes. Results: In mixed-effects regression models in intent-to-treat analyses, CBSST skill knowledge, functioning, amotivation/asociality negative symptoms, and defeatist performance attitudes improved significantly more in CBSST relative to GFSC. In both treatment groups, comparable improvements were also found for positive symptoms and a performance-based measure of social competence. Conclusions: The results suggest CBSST is an effective treatment to improve functioning and experiential negative symptoms in consumers with schizophrenia, and both CBSST and supportive group therapy actively focused on setting and achieving functioning goals can improve social competence and reduce positive symptoms.
Abstract
Objective
Evidence suggests that social skills training (SST) is an efficacious intervention for negative symptoms in psychosis, whereas evidence of efficacy in other psychosis symptom ...domains is limited. The current article reports a comprehensive meta-analytic review of the evidence for SST across relevant outcome measures, control comparisons, and follow-up assessments. The secondary aim of this study was to identify and investigate the efficacy of SST subtypes.
Methods
A systematic literature search identified 27 randomized controlled trials including N = 1437 participants. Trials assessing SST against active controls, treatment-as-usual (TAU), and waiting list control were included. Risk of bias was assessed using the Cochrane risk of bias assessment tool. A series of 70 meta-analytic comparisons provided effect sizes in Hedges’ g. Heterogeneity and publication bias were assessed.
Results
SST demonstrated superiority over TAU (g = 0.3), active controls (g = 0.2–0.3), and comparators pooled (g = 0.2–0.3) for negative symptoms, and over TAU (g = 0.4) and comparators pooled (g = 0.3) for general psychopathology. Superiority was indicated in a proportion of comparisons for all symptoms pooled and social outcome measures. SST subtype comparisons were underpowered, although social-cognitive approaches demonstrated superiority vs comparators pooled. SST treatment effects were maintained at proportion of follow-up comparisons.
Conclusions
SST demonstrates a magnitude of effect for negative symptoms similar to those commonly reported for cognitive-behavioral therapy (CBT) for positive symptoms, although unlike CBT, SST is not routinely recommended in treatment guidelines for psychological intervention. SST may have potential for wider implementation. Further stringent effectiveness research alongside wider pilot implementation of SST in community mental health teams is warranted.
The Program for the Education and Enrichment of Relational Skills (PEERS
) is an intervention targeting social skills for autistic adolescents and those with other social challenges. The efficacy of ...the PEERS
on adolescents has been extensively explored but the program has not been validated in Italy. In the present study, we adapted PEERS
to Italian culture and evaluated its efficacy in an Italian sample. A Randomized Controlled Trial was conducted, analyzing the results of 37 autistic adolescents who were randomly assigned to two groups: experimental group (TG) and waitlist group (WL). The primary outcomes (social abilities) and secondary outcomes (co-occurring conditions, executive functions) were assessed at four time points. No differences were found at pre-treatment between groups on baseline measures and primary outcomes. At post-treatment, significant group differences emerged in primary outcomes (social knowledge and social performance) and secondary outcomes (emotion regulation). The groups' results pooled together (TG + WL) confirmed the findings at post-treatment and showed further changes in primary outcomes (global social competence and social cognition) and secondary outcomes (externalizing problems, emotive and behavioral total problems, functional problems related to depressive symptoms). The improvements were maintained at a 3-month follow-up, except for global social competence and social cognition. Additionally, new results emerged regarding internalizing problems and global executive functioning. The efficacy of the Italian version of PEERS
was ascertained on primary and secondary outcomes. Innovative findings on emotion regulation, behavioral problems, and depression symptoms also emerged.Clinical trial registration information Program for the Education and Enrichment of Relational Skills (PEERS
) for Italy. An RCT's Study on Social Skills Intervention for Adolescents with Autism Spectrum Disorder (ASD). URL: http://clinicaltrials.gov . TRN: NCT05473104. Release Date: July 21, 2022.
Evidence-based social skills interventions for young adults are limited, despite social difficulties in autism spectrum disorder (ASD) persisting after transition to adulthood. The Program for the ...Education and Enrichment of Relational Skills for Young Adults (PEERS®-YA) is an evidence-based intervention found to be effective in improving relational skills in young adults with ASD. To translate the original American version of the PEERS®-YA treatment manual into Korean, intensive interviews were performed. Based on results from interviews, several rules of dating etiquette and social activities were modified to be culturally sensitive and linguistically appropriate. Next, young adults diagnosed with ASD (18–35 years of age; IQ > 70) and their social coaches were recruited for the randomized controlled trial (RCT). Participants were randomly assigned either to a treatment group (TG;
n
= 19) or a delayed treatment group (DTG;
n
= 18). In the analysis of group differences in the TG and DTG, social skills knowledge was improved. The within group analyses showed positive effects of improving social skills knowledge on reducing depression and anxiety symptoms. After modest cultural adaptations focusing on dating and social activities, the implementation of the PEERS®-YA-K was found feasible for the Korean community. This is one of only a few cross-cultural validation trials establishing evidence-based treatment in young adults with ASD.
Clinical Trial Registration:
This trial was registered at
ClinicalTrials.gov
, identifier: NCT03310775.
In the present study, female university students were given training based on a program for improving teamwork competency in order to examine whether their advanced skills improved in relation to ...the contents of the training and to determine the timing of any changes in their basic and advanced skills. The experimental conditions were: (a) communication ability sessions and team-oriented ability training sessions, plus backup ability sessions (n=25), (b) communication ability sessions and team-oriented ability training sessions, plus monitoring ability sessions (n=19), and (c) no training (n=76). All participants' skills were measured before the training, at the end of the basic skills sessions, and after the completion of the training. The results showed that although the participants' scores for the sub-skills did not improve at the end of the basic skills session, they did improve after the end of training, except for the scores on assertiveness and relationship-building skills. The results for the advanced skills sessions suggested the possibility of improving not only the target skills but also basic skills related to the sessions' content and advanced skills other than the target skills. The students' decoding and encoding basic skills improved after they had learned specific usage scenarios in the advanced skills sessions. These results suggest that there may have been a bidirectional relationship between basic skills and advanced skills, that is, they may have influenced each other.
Intervention programs based on Social Skills Training have been researched in different populations, including university students. This study aimed to review the literature about HST programs with ...university students, published in national and international journals, emphasizing the instruments and designs used, in addition to the main results and limitations, from 1980 onwards. The
•Neural circuits drive and shape social learning early in life.•Activate, Integrate, Discriminate, Respond, Reward (AIDRR) circuits are proposed.•Domain markers may identify social delay earlier than ...what is behaviourally observed.•Domain markers may provide objective social learning assessments.•Oxytocin intervention is applied to illustrate application of this model.
Early life social experiences shape neural pathways in infants to develop lifelong social skills. This review presents the first unified circuit-based model of social learning that can be applied to early life social development, drawing together unique human developmental milestones, sensitive learning periods, and behavioral and neural scaffolds. Circuit domains for social learning are identified governing Activation, Integration, Discrimination, Response and Reward (AIDRR) to sculpt and drive human social learning. This unified model can be used to identify social delays earlier in development. We propose social impairments observed in Autism Spectrum Disorder are underpinned by early mistimed sensitive periods in brain development and alterations in amygdala development to disrupt the AIDRR circuits. This model directs how interventions can target neural circuits for social development and be applied early in life. To illustrate, the role of oxytocin and its use as an intervention is explored. The AIDRR model shifts focus away from delivering broad treatments based only on diagnostic classifications, to specifying and targeting the relevant circuits, at the right time of development, to optimize social learning.
The purposes of the present study were to conduct a training program based on a hierarchical structure of social skills that was aimed at improving female university students' teamwork competency, ...and to evaluate effects of the training. The participants were third-year and higher level students at women's universities in the Tokyo area who were taking lecture or seminar courses on interpersonal communication and related topics. Initially, the students were given training in communication ability, a basic skill. After that, the students were trained in more advanced skills, specifically, team orientation and backup abilities. Those students (N=53; average age approximately 20 years) whose questionnaire responses were complete were included in the final analysis. Effects of the program were evaluated by means of an effectiveness measurement scale with content that corresponded to the content of the training program. The results suggested that both encoding and decoding skills, which are sub-skills within communication abilities, improved after the training, compared to a non-training condition. Among the team-oriented and backup abilities, only harmonizing skills, which are a sub-skill of team-oriented abilities, improved significantly. No significant change was found in the other sub-skills of team-oriented and backup abilities. However, performance guidance and problem-solving skills, which are sub-skills within other advanced skills associated with leadership ability, improved even though no training was provided in those areas. In general, the participants' communication abilities improved after they had participated in the training program. Further research should be done on the effects on advanced skills of training basic skills, from the viewpoint of a hierarchical skill structure.
People living with severe mental illness (SMI) are one of the most marginalized groups in society. Interventions which aim to improve their social and economic participation are of crucial importance ...to clinicians, policy‐makers and people with SMI themselves. We conducted a systematic review of the literature on social interventions for people with SMI published since 2016 and collated our findings through narrative synthesis. We found an encouragingly large amount of research in this field, and 72 papers met our inclusion criteria. Over half reported on the effectiveness of interventions delivered at the service level (supported accommodation, education or employment), while the remainder targeted individuals directly (community participation, family interventions, peer‐led/supported interventions, social skills training). We identified good evidence for the Housing First model of supported accommodation, for the Individual Placement and Support model of supported employment, and for family psychoeducation, with the caveat that a range of models are nonetheless required to meet the varied housing, employment and family‐related needs of individuals. Our findings also highlighted the importance of contextual factors and the need to make local adaptations when “importing” interventions from elsewhere. We found that augmentation strategies to enhance the effectiveness of social interventions (particularly supported employment and social skills training) by addressing cognitive impairments did not lead to transferable “real life” skills despite improvements in cognitive function. We also identified an emerging evidence base for peer‐led/supported interventions, recovery colleges and other interventions to support community participation. We concluded that social interventions have considerable benefits but are arguably the most complex in the mental health field, and require multi‐level stakeholder commitment and investment for successful implementation.
UCLA PEERS® for Adolescents is a widely applied program among a number of social skills training programs developed over the years. We synthesized current research evidence on the PEERS program to ...evaluate the treatment effect on four commonly used outcome measures. 12 studies met inclusion criteria for the review and nine met the criteria for meta-analysis. Results showed moderate to large pooled effects across measures and informants in favor of the PEERS program, with the largest effect seen in social knowledge improvement and the smallest effect in the frequency of get-togethers. The heterogeneity of effects across studies were examined and the limitations of the current evidence were discussed.
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