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RESEARCH WEEKLY: Psychosocial Interventions for Schizophrenia
By Shanti Silver
(January 4, 2023) A new year brings new opportunities to advocate for effective and evidence-based treatment for people with severe mental illness. A recent review of the literature from Psychiatric Services explored the effectiveness of psychosocial interventions on people with schizophrenia through reviewing results from more than 200 studies. While the results show that many psychosocial interventions can improve outcomes for people with schizophrenia, the strongest evidence was found for interventions that were comprehensive, integrated and team-based.
Study Details
The research review included studies that were randomized-controlled trials and systemic reviews of randomized-controlled trials. In a randomized-controlled trial, a group of participants are randomly assigned to receive either a new treatment or a reference treatment. This makes it possible to determine if a new treatment is more, less or equally effective as typical treatments. Randomized-controlled trials are considered the strongest evidence for the effectiveness of an intervention in clinical research.
A psychosocial intervention is an intervention that can include therapy, social supports or career training. All studies reviewed in this paper used randomized-controlled trial methodology to test the effectiveness of various psychosocial interventions on the well-being and/or functioning of people with schizophrenia.
Key Findings
The authors identified several forms of treatment for which there was evidence of their positive impact on people with schizophrenia. One of these was assertive community treatment. ACT is an intervention in which a team of psychiatric care providers, nurses, employment specialists and peer specialists work together to assist a person with serious mental illness with living successfully in the community. This study found that people with schizophrenia in assertive community treatment had better outcomes than people with schizophrenia who were in a reference treatment. Specifically, they were more likely to be living independently, less likely to be homeless, more likely to be employed and had less severe symptoms.
Early interventions for first-episode psychosis were also shown to be effective across several studies. These interventions are designed to identify and treat people who are experiencing their first episode of psychosis. In these early interventions, psychiatric care workers, peer specialists, career specialists and family specialists often work together to help a person with psychosis. People in these interventions were more likely to be working or in school after two years of treatment, had higher overall functioning, higher quality of life and were less likely to have experienced a relapse than people with psychosis who were in a reference treatment. People with schizophrenia who received only psychoeducation, an intervention that involves educating people about their diagnosis and treatment options, were also less likely to relapse than those in reference treatments.
Implications
The authors note that while this review did not evaluate all evidence-based psychosocial interventions, results provide a summary of the effectiveness of several psychosocial interventions for people with schizophrenia. In this review, the strongest evidence was found for the effectiveness of assertive community treatment and early interventions for first-episode psychosis. The authors suggest that the relatively strong evidence for these programs points to the importance of integrated, team-based interventions and treatments for people with schizophrenia. When determining which interventions should be made a priority for people with schizophrenia, it may be important to consider that some interventions may not be appropriate for all people with schizophrenia. For example, while first-episode psychosis programs appear to be effective, they may not be appropriate for people who are further along in their illness journey.
As we begin a new year, The Office of Research and Public Affairs remains committed to reporting new research on severe mental illnesses, including schizophrenia. If you have any questions or topics you would like to see featured in Research Weekly this year, we would love to hear from you at [email protected]. Thank you for your continued support of our work!
References
McDonagh, M. S., et al. (March 2022). Psychosocial interventions for adults with schizophrenia: an overview and update of systematic reviews. Psychiatric Services, 73.
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