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Review
. 2018 Apr 6;44(3):475-491.
doi: 10.1093/schbul/sbx146.

A Meta-Analysis of Social Skills Training and Related Interventions for Psychosis

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Free PMC article
Review

A Meta-Analysis of Social Skills Training and Related Interventions for Psychosis

David T Turner et al. Schizophr Bull. .
Free PMC article

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.

Figures

Fig. 1.
Fig. 1.
PRISMA flowchart of inclusion of studies.
Fig. 2.
Fig. 2.
Summary forest plot of significant main results in Hedge’s g. ALL, all comparators pooled; TAU, treatment-as-usual; AC, active controls; Social, social competency outcomes; General, PANSS general symptoms; Negative, negative symptoms; Any, all eligible studies included; <4, <3, and <2 denote sensitivity analyses progressively removing risk of bias.

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