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“The effect sizes reported are impressive for a group-based psychological intervention suggesting that SST may have potential as a cost-effective alternative to individual therapies addressing negative and general symptoms in health care systems struggling to provide routine psychological intervention,” lead author David T. Turner, Ph.D., of Vrije University, The Netherlands, and colleagues wrote.
In recent years, addressing negative symptoms—passive or apathetic social withdrawal, communication difficulties, blunting of affect, and rigid or stereotypical thinking—has been recognized as central to improving quality of life and long-term recovery for patients with schizophrenia. During this time, trials of SST, originally developed in the 1970s to address interpersonal and social functioning, have been expanded to include studies of effects on negative symptoms.
Turner and colleagues searched the literature for randomized, controlled trials of social skills training, including those that compared SST against active controls (such as cognitive-behavioral therapy [CBT]), treatment as usual (standard treatment offered in the clinical setting), and waiting-list controls. Twenty-seven randomized, controlled trials with 1,437 participants were included in the analysis.
SST demonstrated superiority for negative symptoms and for scores on general psychopathology over both treatment-as-usual and active controls, as well as when all comparators were pooled. The effect sizes reported for SST for negative symptoms were “marginally greater than those reported for CBT for positive symptoms and marginally smaller than those reported for antipsychotics,” according to the report. “If we consider CBT as an intervention addressing positive symptoms and SST for negative symptoms, each intervention has effects of roughly equivalent magnitude for its target area,” the researchers stated.
“The meta-analysis by Turner and colleagues … reconfirms the efficacy of social skills training for improving social skills and reducing negative symptoms in people with schizophrenia,” Philip Harvey, Ph.D., of the University of Florida and Eric Granholm, Ph.D., of the University of California, San Diego wrote in a related editorial. “These consistently-replicated findings that SST improves social skills, negative symptoms, and functioning relative to standard care suggests that existing standard services for schizophrenia can be improved by adding SST.”
For related information, see the Psychiatric News article “Study Suggests Cariprazine May Have Direct Effects on Negative Symptoms.”
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