Evaluating the introduction of a condensed Social Cognition Interaction Training (SCIT) program undertaken by individuals living with severe enduring schizophrenia who reside in a Queensland Community Care Unit

Michael Bradburn

doi:10.25907/00723

Deficiencies in social cognition and its relationship to social behaviour and functioning outcomes are hallmark features across the spectrum of people with schizophrenia. Evidence-based mental health rehabilitation and recovery aim to reduce the burden of living with a severe mental illness by developing skills that create a new understanding, purpose, and hope towards the future (Anthony & Mizok 2014). This study aimed to evaluate a condensed social cognition therapeutic model to improve the social functioning behaviour of participants from a Community Care Unit (CCU) in Queensland living with severe enduring schizophrenia. The objectives were (1) to identify participants' baseline social cognition capacity, (2) to provide social cognition skills training, (3) to increase participants’ understanding of emotional and perceptual awareness when engaging with others, (4) to develop confidence about alternative possibilities to their initial negative thoughts about others intent, and (5) determine any benefits from implementing a condensed Social Cognition Interaction Training (SCIT) with participants living with severe enduring schizophrenia. This study used a mixed-method research design. It involved two studies, an implementation and an evaluation. The implementation study used baseline data, and the evaluation used change-over-time data collected from participants and CCU nursing staff directly involved in participants’ care. Qualitative data was collected from participants using weekly feedback questionnaires and the end of SCIT program evaluation session. The site targeted was not addressing social cognition needs, and a gap existed in the literature around the benefits of a condensed model for a high-need population. All 35 CCU residents were eligible and invited to participate in the study. Nine residents agreed to participate in the mixed-method study. The intervention involved 10-weeks of SCIT therapy, with two-hour weekly sessions. The evaluation involved baseline, post-therapy and three-month follow-up psychometric testing using a test-retest method. Participants and all CCU staff received compensation for their time with shopping vouchers, and lunch was provided to participants each week as a mid- therapy break. There were six critical findings, 1. The condensed SCIT therapy did not produce any clinically or statistically significant improvement in the group’s social cognition skill level on measures used. 2. At baseline, CCU participants had more difficulty with social perception (Hinting Task - 13.8 ± 2.9 vs 15.6 ± 3.9 p=0.630) and equivalent difficulty with emotional perception on the BLERT compared to samples derived from the literature. 3. There was no reduction in participants' psychotic symptoms (mean baseline scores 2.44 ± 1.25 compared to post-therapy 2.55 ± 1.06 p=0.87 and follow-up 2.33 ± 0.94 p= 0.86) or levels of hostility bias (baseline 3.67± 100 compared to post-therapy 3.22±1.20 p= 0.40 and to follow-up 3.56 ± 1.50 p=0.42). 4. Average group attendance was 74%, with only one participant attending all 10 therapeutic sessions. 5. Case study results indicated that one individual sustained improved social perception, and two participants improved their emotional perception. 6. Subjectively, the participants felt they learnt new skills, would recommend SCIT to others and were interested in attending follow-up sessions. Future research needs to consider whether a condensed model of SCIT is suitable for a high-need population. Participant selection requires closer examination, given the difficulties that pre-existing paranoia and delusional symptoms have on social skill development. SCIT cannot be considered a standalone therapy and needs incorporation into a multi-focused rehabilitation program that holds the participants' goals, wishes and aspirations as central to their recovery. Future SCIT programs should consider the involvement of (peer support workers) and practice partners to assist in a participant's recovery.

Evaluating the introduction of a condensed Social Cognition Interaction Training (SCIT) program undertaken by individuals living with severe enduring schizophrenia who reside in a Queensland Community Care Unit

Files and links (1)

Abstract

Details

Metrics