sblogo.jpgDelays in implementing recommended psycho-social services as an adjunct to medication can prolong disabilities associated with schizophrenia, write the authors of a study in the on-line Advance Access Schizophrenia Bulletin. In a comprehensive project (citing 233 references), the Schizophrenia Patient Outcomes Research Team (PORT) undertook the third review of research about psychosocial treatments since the initial study came out 15 years ago. They concluded that many recommendations for psychosocial treatment are not followed, used erratically, or categorized inconsistently in research studies.

"The lack of a standardized method to organize treatments and approaches can lead to confusion and mask the fact that different interventions and treatments may share common elements. For example, a reader could erroneously conclude that CBT is useful only for those symptoms identified in the CBT recommendation and fail to appreciate that cognitive behavioral strategies are an integral part of other approaches such as family psychoeducation, supported employment, and treatment for substance abuse."

The research team systematically addressed eight programs: assertive community treatment (ACT); supported employment; skills training; cognitive behavioral therapy (CBT); token economy; family-based services; interventions for substance use disorders; and weight management.

The update was undertaken, in part, to assess whether the previous recommendations needed revisions. They also called attention to promising new interventions while waiting for more evidence to accumulate. These include areas previously "minimized or overlooked" such as cognitive remediation, peer support and delivered services, medication adherence, and recent onset schizophrenia.

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