Category: Dissemination / Implementation

Symposium

Effectiveness of Cognitive-Behavioral Social Skills Training Delivered by ACT Teams for People with Schizophrenia

Friday, November 17
4:15 PM - 5:45 PM
Location: Indigo Ballroom A, Level 2, Indigo Level

Keywords: Clinical Trial | Community-Based Assessment / Intervention | Schizophrenia
Presentation Type: Symposium

Background: Cognitive-behavioral social skills training (CBSST) combines CBT and SST to target recovery outcomes in schizophrenia. Several clinical trials have demonstrated the efficacy of CBSST delivered by highly-trained therapists with masters- or higher-level education. We adapted CBSST for implementation on ACT teams in community mental health settings and report on the effectiveness of CBSST delivered by ACT staff.

Methods: Participants with schizophrenia spectrum disorder were randomized to receive ACT+CBSST (N=83) or ACT-only (N=94) within 9 ACT teams and assessed at 0, 18, 36, 54, and 72 weeks. ACT staff (N=97) received a workshop, weekly consultation and implementation strategies to provide individual CBSST during regular community ACT visits.

Results: The number of sessions delivered per participant was highly variable (range 0-52; M=14; SD=10) with only 33% (N=28) exposed to the full CBSST content (18+ sessions). ITT multi-level models showed only weak added benefit for CBSST+ACT over ACT-only. However, per-protocol analyses of the subgroup of participants exposed to the full CBSST content showed significant added benefit for total and negative symptoms and functioning, and number of CBSST sessions delivered was associated with better outcome for this subgroup.
Discussion: Integrating CBSST into ACT is a promising method for improving recovery outcomes of people with schizophrenia, but only for participants who receive a higher dose of therapy. Research is needed to identify the optimal implementation strategies to promote delivery of EBPs on ACT teams.

Eric Granholm

Professor of Psychiatry and Chief, Psychology Service,
University of California, San Diego and Veterans Affairs San Diego Healthcare System

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Jason Holden

University of California, San Diego

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David Sommerfeld

Assistant Project Scientist
University of California, San Diego

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Peter Link

University of California, San Diego

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