Social skills training for patients with schizophrenia: a controlled clinical trial

Twenty-eight schizophrenic male patients, diagnosed by the Present State Examination and Catego criteria, and from families high on "expressed emotion," were randomly assigned to either intensive social skills training or holistic health therapy. A multidimensional evaluation was conducted before and after 9 weeks of inpatient treatment and for 24 months in the community. Patients exposed to social skills training evidenced significantly greater acquisition, generalization, and durability of social skills; their social adjustment in the community was rated as better by significant others; and they experienced fewer relapses and rehospitalizations.     

Comorbidity training needs at a state psychiatric hospital

This study explored training issues relevant to work with comorbid clients (those with both psychiatric and substance abuse diagnoses) among members of a psychiatric hospital clinical staff (N=147). Respondents reported that they had received limited training for working with comorbid or substance abusing clients; they perceived comorbid clients as presenting with particular concerns, especially regarding referral to treatment services and management of acting-out behaviors; and they attached great importance to the need for training in comorbidity. With high proportions of clients at psychiatric hospitals being comorbid, it is imperative that staff members receive training to deal with substance abuse and comorbidity. These results suggest that such training has not been available, but it is needed and wanted.     

西安市社区居民对康复精神病患者的接纳性问卷调查

目的 探讨西安市社区居民的文化程度、职业和年龄对康复后精神疾病患者的接纳性影响.方法 采用分层整群抽样,抽取西安市4个社区居民进行“精神疾病有关态度”同卷调查.结果 共发放调查问卷1600份,有效调查问卷1591份(99.4％).其中答案“不好说”占很大比例.调查问卷平均得分为(35.20士5.918)分.单因素分析表明与职业、文化程度、年龄均无关(P＞0.05).结论 康复后精神疾病患者是社会的弱势群体,经济收入低、就业难、社会接纳度低,从社区到整个社会要普及精神卫生常识,从根本上为康复后患者创造就业及回归的条件.     

Reliability and validity of communication skills questionnaire (CSQ)

A new and easy evaluation method of communication skills has been developed using the Communication Skills Questionnaire (CSQ), which can be self-administered or administered by family members and medical staff. The reliability and validity of this CSQ were evaluated. Eighty-seven patients with mental disorders and 100 normal controls participated in a self-rating evaluation of the CSQ, and 55 family members and four medical personnel also participated in objective rating. The CSQ contained 29 items and these items were divided into three categories: cooperative skills (17 items), assertive skills (six items) and general communication skills (six items, mainly non-verbal skills). Internal consistencies of all groups were between 0.91 and 0.97. Test-retest reliability values for patients, family members and medical staff were between 0.90 and 0.95. Interrater reliability of medical staff was 0.73. The total scores had a moderate positive correlation with Global Assessment of Functioning (GAF) score and doctor's impression of communication skill evaluated on a 10-point scale. The patient group had a lower CSQ score than that of controls and the score differences between controls and patients with schizophrenia, mood disorders or eating disorders were statistically significant. This questionnaire is a good psychometric method of evaluating the communication skills of patients.     

Maintenance and generalization of skills acquired through picture exchange communication system (PECS) training: a long-term follow-up

ABSTRACT

Purpose: To conduct a follow-up assessment of the maintenance of communication skills of a 7-year-old child with autism spectrum disorder, 3 years 7 months post PECS training; and investigate the effects of environmental adaptations on the child’s PECS and vocal communications.

Methods: An alternating-treatments design enabled comparison of the effects of two treatment conditions (an environmental adaptation to increase need and opportunities for communication, versus a continuation of baseline procedures) on the child’s PECS and vocal communications in the child’s home.

Results: Baseline data demonstrated decreased levels of PECS and vocal communication at follow-up, compared to post PECS training 3 years 7 months prior. The environmental adaptation had no observable effect on the participant’s use of PECS, but vocal manding increased in this condition.

Conclusion: These results suggest ongoing need for motivating environments with ample opportunities to practice post PECS training. Implications and directions for future research are discussed.     

应对技能训练应用于抑郁症患者

目的:探讨应对技能训练对抑郁症患者应对方式的影响。方法:将60例抑郁症患者随机分为研究组30例和对照组30例,研究组给予药物治疗加应对技能训练,对照组仅给予药物治疗。观察8周。于训练前及训练8周采用应付方式问卷评价患者的应对水平。结果:应对技能训练后,在应对方式上,研究组自责、幻想、退避评分低于对照组(P<0.05或P<0.01),而解决问题、求助评分高于对照组(P<0.01)。结论:应对技能训练可部分改善抑郁症患者的应对方式。     

团队技能训练模式在住院精神障碍患者康复中的应用效果分析

目的探讨团队技能训练模式在住院精神障碍患者康复中的应用效果。方法选择我院2011-01—2013-06期间收治的精神障碍住院患者80例,随机分为研究组与对照组,每组各40例。2组仍使用原来治疗方案进行药物治疗,对照组同时给予一定的健康教育和个体康复训练,研究组给予团队技能康复训练。应用日本生活技能训练协会制定的生活技能训练(SST)量表评定患者日常生活能力改善情况,应用简明精神病评定量表(BPRS)评定患者精神症状严重程度,并随访1a观察患者结局。结果 (1)2组患者训练前SST、BPRS评分比较差异无统计学意义(P0.05),训练后研究组SST评分显著提高,BPRS评分显著降低(P0.01),对照组上述评分无显著变化(P0.05)。(2)训练开始后,研究组患者SST评分逐渐升高,训练5周后研究组SST总分显著高于训练前(P0.05)。对照组进行康复训练后SST评分与训练前比较差异无统计学意义(P0.05)。(3)随访1a,研究组病情稳定率显著高于对照组,复发率显著低于对照组(P0.05)。结论团队技能训练可以有效地提高精神障碍患者生活能力,缓解精神症状,提高患者的生活质量。     

Importance of communication training for psychiatric residents and mental health trainees

Through the illustration of a clinical vignette and excerpts from interviews with trainees, this paper suggests that communication and communication disorders are essential issues in child psychiatry training. The vignette shows how communication issues pervade a multidisciplinary psychoeducational day treatment program. The importance of communication in the clinical experience and its impact on the professional preparation of psychiatry residents and mental health trainees are examined, and conclusions and recommendations for the goals of a training program in child psychiatry are presented which expand upon those findings.     

Changes in frontal-parietal activation and math skills performance following adaptive number sense training: Preliminary results from a pilot study

Number sense is believed to be critical for math development. It is putatively an implicitly learned skill and may therefore have limitations in terms of being explicitly trained, particularly in individuals with altered neurodevelopment. A case series study was conducted using an adaptive, computerised programme that focused on number sense and general problem-solving skills. The study was designed to investigate training effects on performance as well as brain function in a group of children with Turner syndrome who are at risk for math difficulties and altered development of math-related brain networks. Standardised measurements of math and math-related cognitive skills as well as functional magnetic resonance imaging (fMRI) were used to assess behavioural and neurobiological outcomes following training. Participants demonstrated significantly increased basic math skills, including number sense, and calculation as well as processing speed, cognitive flexibility and visual-spatial processing skills. With the exception of calculation, increased scores also were clinically significant (i.e., recovered) based on reliable change analysis. Participants additionally demonstrated significantly increased bilateral parietal lobe activation and decreased frontal-striatal and mesial temporal activation following the training programme. These findings show proof of concept for an accessible training approach that may be potentially associated with improved number sense, math and related skills, as well as functional changes in math-related neural systems, even among individuals at risk for altered brain development.     

Complexity of staff communication and reported level of understanding skills in adults with intellectual disability

Staff reports of the communication acts taking place with 22 adults with intellectual disability were compared with video observations of the communication acts used by staff with 12 of these service users. The interactions were coded in terms of the form of communication used, the function of the act and the level of complexity. The results show that staff tend to underestimate their own use of verbal communication and overestimate their use of non‐verbal communication. The findings also indicate a mismatch between the reported level of understanding of the service user and the level of complexity of the language used. Staff appeared unable to adapt their communication to the skills of the service user and an average of 45% of communicative acts were outside the reported understanding skills of the individual. The implications of these findings are discussed and possible explanations for staff behaviour are suggested.     

社会技能训练对32例住院慢性精神分裂症患者的疗效观察

本文对３２例住院慢性精神分裂症病人进行了旨在教授有效的社会技能的治疗，总结一套系统的社会技能训练（ＳＳＴ）方法，经过多维临床检验，ＳＳＴ对病员减轻阴性症状，改善社会交往技能，提高适应性的自信水平等方面有一定效果。文中分析了产生疗效的原因以及进一步提高疗效的办法。     

School-based social skills training for young people with autism spectrum disorders

ABSTRACT

Background: The Secret Agent Society (SAS) Program, an intervention to enhance social–emotional skills, was provided by schools for children with autism spectrum disorder (ASD). The program was assessed to determine if it improved social skills at school and home, and whether improvements were maintained.

Methods: Eighty-four students participated. Key outcomes were parent and teacher ratings of emotion regulation, social skills, and direct child social problem-solving measures. The standard school curriculum served as the control condition. Phase 1 was a two-group waitlist-control comparison of SAS versus the standard curriculum. Phase 2 was a follow up of all participants before and after the intervention and at 12-months post-intervention.

Results: Parent and child measures improved after the intervention but not in the waitlist condition. Improvements in parent, child, and teacher measures were apparent at 12 months.

Conclusions: The SAS Program warrants further research as a potential program for schools that serve children with ASD.     

A pilot study of combining social skills training and parenting training for children with autism spectrum disorders and their parents in Japan

The purpose of this study is to investigate the effects of a program containing a combination of social skills training (SST) and parenting training (PT) for the enrichment of social interaction skills and reduction of parenting stress for children with high-functioning autism spectrum disorder (HFASD) and their parents in Japan. Twenty-two patients with HFASD from second to fourth grade and their parents were assigned to a training group (TG) or treatment as usual (TAU) and compared. The children with HFASD and their parents who were assigned to the TG participated in the manualized program for over a period of five to six months. Subjects provided demographic and medical information and completed teacher and parent-rating scales for social competence (Social Responsiveness Scale-2: SRS-2) and parent-rating of parenting stress (Parental Stress Index: PSI) and mental health (General Health Questionnaire-28: GHQ-28). The participants exhibited some improvements pre-, middle-, and post-treatment, particularly regarding the GHQ, PSI and SRS-2, as reported by parents. However, the social skills improvement reported by teachers was not significant. At the three-month follow-up, parent-rated GHQ and PSI maintained improvement, and SRS-2 achieved the greatest improvement from the baseline rating. Although some findings indicate that a program combination of SST and PT might be useful for enhancing social skills and improving parental stress and mental health, some subscales did not show a sufficient effect. Future research should consider program contents and provide longitudinal follow-up data to test the durability of the treatment.     

A component analysis of a behavioral skills training package used to teach conversation skills to young adults with autism spectrum and other developmental disorders

We conducted a component analysis of a behavioral skills training (BST) package to teach conversation skills to young adults with autism and/or developmental disorders. Performance following each component of the package was compared to a task analysis that included both vocal and non-vocal conversation skills, such as making comments related to the conversation topic, maintaining eye contact, maintaining and appropriate distance from the conversation partner. The components of the BST package included instructions, modeling of an appropriate conversation, rehearsal, rehearsal with feedback, in situ training with feedback provided to the participants in a private training room, and in situ training with feedback plus reinforcement. Results suggested unique components were correlated with acquisition of the conversation skills across participants. Results are presented as they relate to effective components of BST and implications for providing BST to individuals in clinical contexts.     

家属参与的社会技能训练对社区精神分裂症患者康复的作用

目的:探讨家属参与的社会技能训练对社区精神分裂症患者康复的影响。方法:80例社区的精神分裂症患者随机分为试验组和对照组;在抗精神病药物治疗基础上所有患者在社区接受每周1次、每次60 min的社会技能训练,共训练16次。试验组每例患者均有1位家属参与训练,其接受治疗师单独指导及在家庭生活中帮助患者实践所学到的技能。两组在训练前、训练6及12个月时分别进行大体评定量表(GAS)、社会功能缺陷筛选量表(SDSS)、自知力和治疗态度问卷(ITAQ)及日常生活量表(ADLS)的评定。结果:训练后试验组SDSS(F=4.02,P0.05)、ADLS(F=12.73,P0.01)及工具性日常生活活动量表(IADL)(F=15.11,P0.01)减分值明显优于对照组。结论:有家属参与的社会技能训练能更好地帮助社区精神分裂症患者康复。     

A component analysis of behavioral skills training for effective instruction delivery

Behavioral skills training is a frequently utilized strategy for promoting skill proficiency, and is utilized with a wide range of individuals (e.g., children, parents, teachers). Although previous researchers have attempted to identify the active components within behavioral skills training, limited experimental control, lack of experimental design, and sequence effects have limited the ability to identify active components. The current study sought to address limitations of previous efforts to identify active components of behavioral skills training. In Experiment 1, components of behavioral skills training were systematically introduced to evaluate additive effects. Eight parents were randomly assigned to one of our behavioral skills training sequences, with each sequence differing in the order in which components of behavioral skills training were introduced. Results indicated that Feedback was most effective for five of eight parents. In order to determine the necessity of Feedback, Experiment 2 was conducted in which Feedback was only introduced after all other components of behavioral skills training had been implemented. Results indicated improved integrity following the introduction of Feedback. Overall, results of the two experiments indicate the necessity of Feedback within behavioral skills training.     

Wandering behavior in veterans with psychiatric diagnoses residing in nursing homes

OBJECTIVE: To investigate nursing home residents with psychiatric diagnoses who wander and who are not diagnosed with dementia. METHOD: A national cross-sectional study was conducted in a male Veterans Administration Nursing Home Care Unit population using a retrospective review of the MDS. RESULTS: Eleven thousand six hundred and nineteen residents were identified as having a psychiatric diagnosis without significant cognitive impairment; just under 1% (n = 113) wandered. Using rare events logit regression, we determined that a diagnosis of schizophrenia/bipolar disorder or comorbid psychiatric conditions were associated with increased risk of wandering compared to residents diagnosed with anxiety/depression. Psychiatric wanderers were also more likely to, have symptoms of delirium, exhibit socially inappropriate behavior, manifest problems in decision-making, take anti-psychotic medications, and to be more independent in locomotion. CONCLUSIONS: Psychiatric wanderers may be conceptualized better as exhibiting ambulatory concomitants of unremitted neurological/psychiatric symptoms or medication side effects of their treatment. Findings have implications for addressing treatable causes of wandering.     

Verbal communication outcomes in children with autism after in-home father training

Background This retrospective study examined the efficacy of in‐home father training on the communicative outcomes of children with autism. The in‐home training consisted of two components: (1) expectant waiting; and (2) imitation with animation. Methods Efficacy of parent training was examined by measuring the ratio of utterances produced by the parents to the utterances produced by the children and the number of verbal imitation by the parents. Outcomes of the children's verbal production were examined by measuring the number of (1) single word utterances; (2) different words produced; and (3) verbal response to questions. Results Following training there was a decrease in the ratio of parent to child utterances and an increase in (1) the use of imitation by the parents; and (2) the number of single words and different words produced by the children. Discussion Results of this study suggested that the parents had learned to wait for their children to communicate verbally during communicative interactions and to interact more efficiently with their children by using verbal imitation. Overall, the results of this study support the efficacy of parent training that focuses on promotion of social reciprocity, and have important implications for clinicians and future research.