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Psychiatr Prax 2012; 39(08): 371-380
DOI: 10.1055/s-0032-1327289
Übersicht
© Georg Thieme Verlag KG Stuttgart · New York

Das Training sozialer Fertigkeiten bei schweren psychischen Erkrankungen – ist es wirksam?

Eine systematische ÜbersichtSocial Skills Training in Severe Mental Illness – Is it Effective?A Systematic Review
Uta Gühne
1   Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
,
Stefan Weinmann
2   Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), Berlin
,
Katrin Arnold
3   Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg
,
Thomas Becker
3   Klinik für Psychiatrie und Psychotherapie II der Universität Ulm am Bezirkskrankenhaus Günzburg
,
Steffi Riedel-Heller
1   Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig
› Author Affiliations
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Publication History

Publication Date:
08 November 2012 (online)

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Zusammenfassung

Anliegen: Darstellung der Evidenz zur Wirksamkeit des Trainings sozialer Fertigkeiten bei Menschen mit schweren psychischen Erkrankungen.

Methode: Systematische Literaturrecherche nach systematischen Reviews und randomisierten Studien (RCTs) in elektronischen Datenbanken und zusätzliche Handsuche.

Ergebnisse: Vier Reviews und 7 RCTs weisen auf signifikante Effekte hinsichtlich erweiterter sozialer Fertigkeiten sowie einer verbesserten sozialen Anpassung der Betroffenen hin. Weniger eindeutig sind die Effekte auf andere Zielgrößen.

Schlussfolgerungen: Menschen mit schweren psychischen Erkrankungen sollten ein Training sozialer Fertigkeiten erhalten, das bei Vorliegen kognitiver Defizite durch kognitive Übungsstrategien ergänzt werden sollte. Erforderlich sind Techniken, die den Transfer in den Alltag unterstützen.

Abstract

Objective: To report about existing evidence of effectiveness of social skills training for severely mentally ill adults.

Methods: Systematic electronic and manual literature search for systematic reviews and randomized clinical trials (RCTs).

Results: Social skills training is a widely used intervention for people with severe mental illness. We identified four reviews and seven RCTs demonstrating the efficacy and effectiveness of social skills training. Results suggest that patients would benefit from trainings by improving social skills and social functioning. There are ambiguous results regarding other outcomes.

Conclusions: People with severe mental illness should be provided with social skills training, if necessary, combined with cognitive remediation. Those techniques are required which actively support the generalization of positive achievements into patients’ natural environments.

Schlüsselwörter

schwere psychische Störungen - Training sozialer Fertigkeiten - psychosoziale Interventionen - Wirksamkeit - Evidenz

Keywords

severe mental illness - social skills training - psychosocial treatment - efficacy - evidence
 

  • Literatur

  • 1 Pfammatter M, Lächler M, Brenner HD. Soziale Fertigkeiten. In: Rössler W, Hrsg. Psychiatrische Rehabilitation. Berlin: Springer; 2004: 195-217
    CrossrefGoogle Scholar
  • 2 Kopelowicz A, Liberman RP, Zarate R. Recent advances in social skills training for schizophrenia. Schizophr Bull 2006; 32: 12-23
    CrossrefPubMedGoogle Scholar
  • 3 Bellack AS, Mueser K. Psychosocial treatment of schizophrenia. Schizophr Bull 1993; 19: 317-336
    CrossrefPubMedGoogle Scholar
  • 4 Bustillo J, Lauriello J, Horan W et al. The psychosocial treatment of schizophrenia: an update. Am J Psychiatry 2001; 158: 163-175
    Google Scholar
  • 5 Liberman RP, Mueser K, Wallace CJ et al. Training skills in the psychiatrically disabled: learning coping and competence. Schizophr Bull 1986; 12: 631-647
    CrossrefPubMedGoogle Scholar
  • 6 Roder V, Mueller DR, Mueser KT et al. Integrated psychological therapy (IPT) for schizophrenia: is it effective?. Schizophr Bull 2006; 32 (Suppl. 01) S81-S93
    CrossrefPubMedGoogle Scholar
  • 7 Glynn SM, Marder SR, Liberman RP et al. Supplementing clinic-based skills training with manual-based community support sessions: effects on social adjustment of patients with schizophrenia. Am J Psychiatry 2002; 159: 829-837
    CrossrefPubMedGoogle Scholar
  • 8 Liberman RP, Glynn SM, Blair KE. In vivo amplified skills training: promoting generalization of independent living skills for clients with schizophrenia. Psychiatry 2002; 65: 137-155
    CrossrefPubMedGoogle Scholar
  • 9 Bellack AS, Bennett ME, Gearon JS et al. A randomized clinical trial of a new behavioral treatment for drug abuse in people with severe and persistent mental illness. Arch Gen Psychiatr 2006; 63: 426-432
    CrossrefPubMedGoogle Scholar
  • 10 Granholm E, McQuaid JR, McClure FS et al. A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. Am J Psychiatry 2005; 162: 520-529
    Google Scholar
  • 11 Bartels SJ, Forester B, Mueser KT. Enhanced skills training and health care management for older adults with severe mental illness. Community Ment Health J 2004; 40: 75-90
    CrossrefPubMedGoogle Scholar
  • 12 McQuaid JR, Granholm E, McClure FS. Development of an integrated cognitive-behavioral and social skills training intervention for older adult patients with schizophrenia. J Psychother Prac Res 2000; 9: 149-156
    PubMedGoogle Scholar
  • 13 Parabiaghi A, Bonetto C, Ruggeri M et al. Severe and persistent mental illness: a useful definition for prioritizing community-based mental health service interventions. Soc Psychiatry Psychiatr Epidemiol 2006; 41: 457-463
    CrossrefPubMedGoogle Scholar
  • 14 Ruggeri M, Leese M, Thornicroft G et al. Definition and prevalence of severe and persistent mental illness. Br J Psychiatry 2000; 177: 149-155
    CrossrefPubMedGoogle Scholar
  • 15 Pilling S, Bebbington P, Kuipers E et al. Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychol Med 2002; 32: 783-791
    Google Scholar
  • 16 Pfammatter M, Junghan UM, Brenner HD. Efficacy of psychological therapy in schizophrenia: conclusions from meta-analyses. Schizophr Bull 2006; 32 (Suppl. 01) S64-S80
    Google Scholar
  • 17 Kurtz MM, Mueser KT. A meta-analysis of controlled research on social skills training for schizophrenia. J Consult Clin Psychol 2008; 76: 491-504
    Google Scholar
  • 18 NICE. Schizophrenia. Core interventions in the treatment and management of schizophrenia in adults in primary and secundary care. NICE Clinical Guideline 82. London: 2009 www.nice.org.uk
    PubMedGoogle Scholar
  • 19 Marder SR, Wirshing WC, Mintz J. Two-year outcome of social skills training and group psychotherapy for outpatients with schizophrenia. Am J Psychiatry 1996; 153: 1585-1592
    CrossrefPubMedGoogle Scholar
  • 20 Liberman RP, Wallace CJ, Blackwell G et al. Skills training versus psychosocial occupational therapy for persons with persistent schizophrenia. Am J Psychiatry 1998; 155: 1087-1091
    CrossrefPubMedGoogle Scholar
  • 21 Hodel B, Kern RS, Brenner HD. Emotional Management Training (EMT) in persons with treatment-resistent schizophrenia: first results. Schizophr Res 2004; 68: 107-108
    CrossrefPubMedGoogle Scholar
  • 22 Roder V, Zorn P, Müller D et al. Improving recreational, residential, and vocational outcomes for patients with schizophrenia. Psychiatr Serv 2001; 52: 1439-1441
    CrossrefPubMedGoogle Scholar
  • 23 Roder V, Brenner HD, Müller D. Development of specific social skills training programmes for schizophrenia patients: results of a multicentre study. Acta Psychiatr Scand 2002; 105: 363-371
    CrossrefPubMedGoogle Scholar
  • 24 Liberman RP, Wallace CJ, Blackwell G et al. Innovations in skills training for the seriously mental ill: the UCLA Social and Independent living Skills Moduls. Innov Res 1993; 2: 43-60
    PubMedGoogle Scholar
  • 25 Horan W, Kern RS, Shokat-Fadai K et al. Social cognitive skills training in schizophrenia: an initial efficacy study of stabilized outpatients. Schizophr Res 2009; 107: 47-54
    CrossrefPubMedGoogle Scholar
  • 26 Galderisi S, Piegari G, Mucci A et al. Social skills and neurocognitive individualized training in schizophrenia: comparison with structured leisure activities. Eur Arch Psychiatry Clin Neurosci 2009; DOI: DOI: 10.1007/s00406-009-0078-1.
    PubMedGoogle Scholar
  • 27 Xiang YT, Weng YZ, Li WY et al. Efficacy of the Community Re-Entry Module for patients with schizophrenia in Beijing, China: outcome at 2-year follow-up. Br J Psychiatry 2007; 190: 49-56
    CrossrefPubMedGoogle Scholar
  • 28 Kern RS, Green MF, Mitchell S et al. Extensions of errorless learning for social problem-solving deficits in schizophrenia. Am J Psychiatry 2005; 162: 513-519
    CrossrefPubMedGoogle Scholar
  • 29 Hogarty GE, Flesher S, Ulrich R. Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Arch Gen Psychiatr 2004; 61: 866-876
    CrossrefPubMedGoogle Scholar
  • 30 Hogarty GE, Greenwald DP, Eack SM. Durability and mechanism of effects of Cognitive Enhancement Therapy. Psychiatr Serv 2006; 57: 1751-1757
    CrossrefPubMedGoogle Scholar
  • 31 Silverstein SM, Spaulding WD, Menditto AA et al. Attention shaping: a reward-based learning method to enhance skills training outcomes in schizophrenia. Schizophr Bull 2009; 35: 222-232
    CrossrefPubMedGoogle Scholar
  • 32 Moriana JA, Alarcon A, Herruzo J. In-home psychological skills training for patients with schizophrenia. Psychiatr Serv 2006; 57: 260-262
    CrossrefPubMedGoogle Scholar
  • 33 Patterson TL, Mausbach BT, McKibbin C. Functional adaptation skills training (FAST): a randomized trial of a psychosocial intervention for middle-aged and older patients with chronic psychotic disorders. Schizophr Res 2006; 86: 291-299
    CrossrefPubMedGoogle Scholar
  • 34 Roder V, Brenner HD, Kienzle N et al. Integriertes Psychologisches Therapieprogramm (IPT) für schizophrene Patienten. Weinheim: Psychologie Verlags Union; 1992
    Google Scholar
  • 35 Corrigan PW. Social skills training in adult psychiatric populations: a meta-analysis. J Behav Ther Experiment Psychiatry 1991; 22: 203-210
    PubMedGoogle Scholar
  • 36 Benton MK, Schroeder HE. Social skills training with schizophrenics: a meta-analytic evaluation. J Consult Clin Psychol 1990; 58: 741-747
    PubMedGoogle Scholar
  • 37 Kunz R, Oxman AD. The unpredictability paradox: review of empirical comparisons of randomised and non-randomised clinical trails. Br Med J 1998; 317: 1185-1190
    CrossrefPubMedGoogle Scholar
  • 38 Wancata J, Meise U. Social Psychiatry – Contradiction to Biological Psychiatry and Psychotherapy?. Psychiat Prax 2010; 37: 317-318
    Article in Thieme ConnectPubMedGoogle Scholar
  • 39 Bellack AS. Skills training for people with severe mental illness. Psychiatr Rehab J 2004; 27: 375-391
    PubMedGoogle Scholar
  • 40 Tauber R, Wallace CJ, Lecomte T. Enlisting indigenous community supporters in skills training programs for persons with severe mental illness. Psychiatr Serv 2000; 51: 1428-1432
    CrossrefPubMedGoogle Scholar
  • 41 Kopelowicz A, Zarate R, Smith VG et al. Disease management in Latinos with schizophrenia: A family-assisted, skills training approach. Schizophr Bull 2003; 29: 211-228
    CrossrefPubMedGoogle Scholar
  • 42 Spaulding WD, Fleming SK, Reed D et al. Cognitive functioning in schizophrenia: implications for psychiatric rehabilitation. Schizophr Bull 1999; 25: 275-289
    CrossrefPubMedGoogle Scholar
  • 43 Hogarty GE, Flesher S. Practise principles of cognitive enhancement therapy for schizophrenia. Schizophr Bull 1999; 25: 693-708
    CrossrefPubMedGoogle Scholar
  • 44 Penn DL, Roberts DL, Combs D et al. The development of the Social and Interaction Training Program for schizophrenia spectrum disorders. Psychiatr Serv 2007; 58: 449-451
    CrossrefPubMedGoogle Scholar
  • 45 Combs D, Adams SD, Penn DL. Social Cognition and Interaction Training (SCIT) for inpatients with schizophrenia spectrum disorders: preliminary findings. Schizophr Res 2007; 91: 112-116
    CrossrefPubMedGoogle Scholar
  • 46 Berger H. Wege in die Zukunft – Einige Skizzen zur Weiterentwicklung der Psychiatrie in Deutschland. Psychiat Prax 2010; 37: 202-205
    Article in Thieme ConnectPubMedGoogle Scholar
  • 47 Falloon IRH, Montero I, Sungur M et al. Implementation of evidence-based treatment for schizophrenic disorders: two-year outcome of an international field trial of optimal treatment. World Psychiatry 2004; 3: 104-109
    PubMedGoogle Scholar
  • 48 DGPPN. S3 Praxisleitlinien in Psychiatrie und Psychotherapie. Band 1 Behandlungsleitlinie Schizophrenie. Darmstadt: Steinkopff Verlag; 2006
    Google Scholar