Life skills training in schizophrenia

Rehabilitation approaches incorporating life skills training are widely employed in the treatment of individuals with schizophrenia. However, whether such approaches are effective is unknown (Nicol et al 2003). This pilot study assessed the effectiveness of a life skills training intervention for people with a diagnosis of schizophrenia, facilitated by occupational therapists working in community mental health teams. Seventeen clients with a diagnosis of schizophrenia and a life skill deficit or deficits were recruited from two National Health Service trusts and participated in up to 12 sessions of life skills training, based upon a treatment manual written specifically for the study. The intervention was facilitated by eight occupational therapists who received training in life skills therapy. A pre-intervention and post-intervention experimental design was used to assess the effectiveness of the programme, with measures of psychiatric symptoms and social functioning being conducted by an independent assessor who was naïve to the intervention being used. For the 13 participants who completed the life skills intervention, participation was found to reduce negative symptoms and overall levels of general psychopathology, although this was not reflected in social functioning. Indeed, a statistically non-significant deterioration in social functioning was found upon completion of the intervention. This uncontrolled study does not allow definitive evaluation of the value of life skills training in schizophrenia, but it does provide justification for a larger-scale controlled trial of a manual based approach to life skills training with this client group.