Do individuals with schizophrenia and a borderline intellectual disability benefit from psychoeducational groups?

Strategies for Achieving Better Cognitive Health in Individuals with Schizophrenia Spectrum: A Focus on the Canadian Landscape: Stratégies pour atteindre une meilleure santé cognitive chez les personnes souffrant du spectre de la schizophrénie : un regard sur le paysage canadien

BACKGROUND

Schizophrenia spectrum disorders (SSDs) are a group of psychiatric disorders characterized by positive and negative symptoms as well as cognitive impairment that can significantly affect daily functioning.

METHOD

We reviewed evidence-based strategies for improving cognitive function in patients with SSDs, focusing on the Canadian landscape.

RESULTS

Although antipsychotic medications can address the positive symptoms of SSDs, cognitive symptoms often persist, causing functional impairment and reduced quality of life. Moreover, cognitive function in patients with SSDs is infrequently assessed in clinical practice, and evidence-based recommendations for addressing cognitive impairment in people living with schizophrenia are limited. While cognitive remediation (CR) can improve several domains of cognitive function, most individuals with SSDs are currently not offered such an intervention. While the development of implementation strategies for CR is underway, available and emerging pharmacological treatments may help overcome the limited capacity for psychosocial approaches. Furthermore, combining pharmacological with non-pharmacological interventions may improve outcomes compared to pharmacotherapy or CR alone.

CONCLUSION

This review highlights the challenges and discusses the potential solutions related to the assessment and management of cognitive impairment to help mental health-care practitioners better manage cognitive impairment and improve daily functioning in individuals with SSDs.

The Development and Evaluation of a Life Skills Programme for Young Adult Offenders

The purpose of this research project was to develop, implement, and evaluate a Life Skills programme for young adult male long-term offenders with the aim of improving their life skills that, in turn, could enable them to adjust more effectively in the correctional environment. Experimental research was used to investigate the effectiveness of the programme. In this study, 96 literate young adult male offenders between the ages of 21 and 25 years, with long sentences, were selected randomly. The participants were assigned randomly into an experimental and a control group. The Solomon four-group design was utilized to control for the effect of pretest sensitization. The measurements of the effectiveness of the programme were conducted before the programme commenced, directly (short term) after, 3 months (medium term) after, and 6 months (long term) after. The findings indicated that the programme had limited success in equipping the offenders with the necessary skills crucial to their survival in a correctional centre. The programme did, however, have significant effects, especially on problem solving and anger management in the short and medium term. These improvements were not long lived.

Patients', Family Members', and Professional Carers' Experiences of Psychoeducational Multifamily Groups for Participants with Intellectual Disabilities and Mental Illness

There is a dearth of articles addressing psychoeducational multifamily groups for adults with intellectual disabilities. The objective of this study is to investigate the participants' experiences of being part of a group like this. The group intervention had been slightly modified due to the participants' intellectual disabilities. Four patients, their close relatives, and community professional caregivers were interviewed using a semi-structured scheme. The four patients had participated in different groups. Three of them had autism spectrum disorder in addition to intellectual disabilities and mental illness. None of the patients were in the most acute phase during the group intervention. Topics discussed in the group sessions encompassed friendship, personal economy, hygiene, understanding of mental illness, and the need for help. A basic meal was served at every group meeting. The experiences were favorable.

Brief heterogeneous inpatient psychotherapy groups: a process-oriented psychoeducational (POP) model

In the United States, there is currently an increase in admissions to psychiatric hospitals, diagnostic heterogeneity, briefer stays, and a lack of inpatient research. Most traditional group therapy models are constructed for longer-term homogeneous patients. Diagnostically homogeneous groups even outperform heterogeneous groups. However, changes in health care have created a clinical dilemma in psychiatric hospitals where groups have become characterized by brief duration, rapid turnover, and diagnostic heterogeneity. A literature review offered little in the way of treatment recommendations, let alone a model or empirical basis, for facilitating these types of groups. Common factors from group therapy studies were extracted. Based on an integration of these studies, a process-oriented psychoeducational (POP) treatment model is recommended. This model is theoretically constructed and outlined for future study.

Benefits and harms of providing biological causal models in the treatment of psychosis--an experimental study

BACKGROUND AND OBJECTIVES

Although many studies have investigated the impact of causal models on public attitudes toward people with psychosis, the effect of causal models on patients with psychosis is unclear. Clinicians must therefore decide about providing causal information without knowing how it will impact on patient and treatment. This study investigates the effect of causal models on different aspects of treatment motivation.

METHODS

In an experimental online study healthy individuals (n = 461) were instructed to imagine experiencing psychotic symptoms and seeking professional help. The imagination was supported by an audio play cover story. Subsequently, participants were randomized to four conditions differing in the content of the causal model given for the occurring symptoms (biological, psychological, combined and no causal explanation).

RESULTS

Different causal models impacted on different aspects of treatment motivation: Participants who had received a biological causal model showed high willingness to take medication, whereas participants who had received a psychological model reported high perceived personal control over symptoms. Participants who had received a causal model that combined biological and psychological aspects reported high acceptance of medication and high motivation to undergo treatment by this clinician.

CONCLUSIONS

The results underline the impact the content of a causal model may have on patients' treatment motivation and - as a consequence - on treatment success. Overall, the integration of psychological and biological aspects within a causal model seems most promising in terms of adherence to various types of treatment.