An Update on CBT with Schizophrenia (with outcome data)

Subj: Schizophrenia Update #85

Date: 8/24/98 7:14:59 AM Eastern Daylight Time

From: brianc@infomaniac.com (Brian Chiko)

Talk therapy can help schizophrenics when combined with Medication

Cognitive behavior therapy -- a counseling technique in which patients learn how to change their thought processes, behavior, and emotions -- may help alleviate schizophrenia symptoms when used in combination with medication, according to a report in the British Medical Journal.

Despite effective drug treatments, many patients with schizophrenia continue to suffer from persistent hallucinations, delusions and other distressing symptoms, according to study author Dr. Nicholas Tarrier, a professor of clinical psychology at the University of Manchester, UK, and colleagues.

In the new study, 79 patients with chronic schizophrenia, were divided into three groups: one that received medication and routine psychiatric care; a second that underwent cognitive therapy in addition to routine treatment; and a third that received "supportive counseling" in addition to routine treatment.

Patients who received cognitive behavior therapy were taught specific methods for coping with their symptoms, along with problem solving and strategies to reduce risk of relapse. Patients in the supportive counseling group received "emotional support through the development of a relationship that fostered rapport and unconditional regard for the patient." Sessions for both additional treatments were carried out twice a week for 10 weeks.

The researchers concluded that patients receiving cognitive behavior therapy showed the greatest improvement; patients receiving routine care alone showed minimal change, and those who received supportive counseling showed some improvement but less than those who received cognitive behavior therapy.

Of the 79 patients in the study, 18 achieved a 50% improvement in psychotic symptoms, both in severity and the number of symptoms. Eleven of these were in the cognitive behavior therapy group, four in the supportive counseling group, and three in the routine care group. Those in the cognitive behavior group were almost eight times more likely to show a 50% reduction in symptoms than did those in routine care alone, wrote the authors. "We tentatively conclude that cognitive behavior therapy, used as an adjunct treatment for chronic schizophrenia, can result in clinical benefits in the short term."

SOURCE: British Medical Journal 1998;317:303-307.

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