Cognitive Behavioral Social Skills Training

An Evidence-Based Practice

Description

Cognitive Behavioral Social Skills Training (CBSST) is a program for middle-aged and older outpatients with chronic schizophrenia. The program teaches cognitive and behavioral coping techniques, social functioning skills, problem-solving, and compensatory aids for neurocognitive impairments. Consisting of 24 to 36 weeks of 2-hour group psychotherapy sessions (1 session per week), CBSST targets the range of multidimensional deficits that can lead to disability in middle-aged and older people with schizophrenia. The social skills training component is based on modules for symptom management, communication role-play, and problem-solving social skills developed by Psychiatric Rehabilitation Consultants, a group of clinicians and researchers from the University of California, Los Angeles. The cognitive behavioral training component of CBSST was specifically developed for patients with schizophrenia. The compensatory aids are designed to address the cognitive impairment associated with both aging and schizophrenia. The program incorporates modifications specific to this target population, such as identifying and challenging ageist beliefs (e.g., "I'm too old to learn"), age-relevant role-play situations (e.g., talking to a doctor about eyeglasses), and age-specific problem-solving (e.g., finding transportation, coping with hearing and vision problems).

Goal / Mission

The goal of this program is to reduce disability in middle-aged and older people with schizophrenia.

Impact

At the end of treatment, CBSST participants had significantly greater cognitive insight scores, indicating more objectivity in reappraising psychotic symptoms relative to treatment as usual. At 1-year follow-up, participants in CBSST showed greater skill acquisition and significant improvements in social functioning relative to participants receiving treatment as usual.

Results / Accomplishments

At 1-year follow-up, participants in CBSST showed significant improvements in social functioning relative to participants receiving treatment as usual, t = 2.01, p = 0.05, d = 0.50. However, no differences between CBSST and treatment as usual were found in participants' capacity to perform basic everyday activities as measured by the UPSA.

At the end of treatment, CBSST participants had significantly greater cognitive insight scores, indicating more objectivity in reappraising psychotic symptoms relative to treatment as usual, f = 9.91, p < 0.01. However, this was not maintained at 1-year follow-up.

At the end of treatment, CBSST participants showed significantly greater skill acquisition than participants receiving treatment as usual, F = 34.78, p < 0.01. This gain was maintained at 1-year follow-up, t = 2.10, p < 0.05.

About this Promising Practice

Organization(s)
University of California, San Diego and VA San Diego Healthcare System
Primary Contact
Cognitive Behavioral Social Skills Training
info@cbsst.org
http://www.cbsst.org/
Topics
Health / Mental Health & Mental Disorders
Organization(s)
University of California, San Diego and VA San Diego Healthcare System
Source
SAMHSA's National Registry of Evidence-Based Programs and Practices (NREPP)
Date of publication
Nov 2006
Location
San Diego, CA
For more details
http://www.cbsst.org/
Target Audience
Adults

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An Evidence-Based Practice meets the following HCI criteria:

  1. The program description includes at a minimum: the sponsoring organization, program goals, program implementation steps, and outcomes that have demonstrated program success in achieving the program goal in one or more localities.
  2. The results from an evaluation of the program include quantitative measures showing improvement in the outcome(s) of interest after the implementation of the program (i.e. increase in smoking cessation, not just the delivery of a smoking cessation program). The outcome measure(s) is/are compared at relevant time periods before and after the intervention or program implementation. Alternatively, the evaluation study compares the outcome(s) between an intervention group and an appropriate control group.
  3. The study is of peer-review quality and presents numbers in a scientific manner; measurements of precision and reliability are included (e.g. confidence intervals, standard errors), results from statistical tests show a significant difference or change in the outcome measure(s), and relevant point estimates and p-values are presented. Note: if the results from an evaluation of a program are presented in a scientific manner and the outcome measure is improved compared to the baseline measurement or the control group but the difference is not statistically significant, the practice is classified as effective and not evidence-based.