Randomized clinical trial of cognitive behavioral social skills training for schizophrenia: improvement in functioning and experiential negative symptoms

J Consult Clin Psychol. 2014 Dec;82(6):1173-85. doi: 10.1037/a0037098. Epub 2014 Jun 9.


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.

Trial registration: ClinicalTrials.gov NCT00338975.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Cognition
  • Cognitive Behavioral Therapy / methods*
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Negativism
  • Problem Solving
  • Psychotic Disorders / psychology
  • Psychotic Disorders / therapy*
  • Schizophrenia / therapy*
  • Schizophrenic Psychology*
  • Social Adjustment*
  • Social Skills*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT00338975