Cited by 887Schizophrenia research and treatmentCounseling, Therapy, and Family DynamicsFamily Caregiving in Mental Illness

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. Psychological treatments in schizophrenia: I. meta-analysis of family intervention and cognitive behaviour therapy.

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PILLING, S., BEBBINGTON, P., KUIPERS, E., GARETY, P., GEDDES, J., ORBACH, G., MORGAN, C.·2002·Psychological Medicine

DOI 10.1017/s0033291702005895

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Abstract

Background. While there is a growing body of evidence on the efficacy of psychological interventions for schizophrenia, this meta-analysis improves upon previous systematic and meta-analytical reviews by including a wider range of randomized controlled trials and providing comparisons against both standard care and other active interventions. Method. Literature searches identified randomized controlled trials of four types of psychological interventions: family intervention, cognitive behavioural therapy (CBT), social skills training and cognitive remediation. These were then subjected to meta-analysis on a variety of outcome measures. This paper presents results relating to the first two. Results. Family therapy, in particular single family therapy, had clear preventative effects on the outcomes of psychotic relapse and readmission, in addition to benefits in medication compliance. CBT produced higher rates of ‘important improvement’ in mental state and demonstrated positive effects on continuous measures of mental state at follow-up. CBT also seems to be associated with low drop-out rates. Conclusions. Family intervention should be offered to people with schizophrenia who are in contact with carers. CBT may be useful for those with treatment resistant symptoms. Both treatments, in particular CBT, should be further investigated in large trials across a variety of patients, in various settings. The factors mediating treatment success in these interventions should be researched.

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Bechdolf, A., Ruhrmann, S., Wagner, M., Kuhn, K., Janssen, B., Ronald Bottlender, A., Wieneke, A., Schulze-Lutter, F., Maier, W., & Klosterkötter, J. (2005) · The British Journal of Psychiatry · doi:10.1192/bjp.187.48.s45 · Cited by 70
“…CBT in schizophrenia has been established for persistent psychotic symptoms in a number of investigations (see meta-analyses by Rector & Beck, 2001; Gould et al, 2002; Pilling et al, 2002; Cormac et al, 2003), one could hypothesise that such an approach is also effective in the prepsychotic phase.”
Background
Cognitive and neural strategies during control of the anterior cingulate cortex by fMRI neurofeedback in patients with schizophrenia
Cordes, J. S., Mathiak, K. A., Dyck, M., Alawi, E. M., Gaber, T. J., Zepf, F. D., Klasen, M., Zvyagintsev, M., Gur, R. C., & Mathiak, K. (2015) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2015.00169 · Cited by 69
“Cognitive behavioral therapy was found to be effective in patients with schizophrenia (Pilling et al., 2002b; Rector and Beck, 2012), even as performed within brief interventions (Turkington et al., 2002) as well as in long-term follow-ups (Sensky et al., 2000; Gould et al., 2001).”
Background
Stress sensitivity mediates the relationship between traumatic life events and attenuated positive psychotic symptoms differentially by gender in a college population sample.
Gibson, L. E., Anglin, D. M., Klugman, J., Reeves, L. E., Fineberg, A. M., Maxwell, S. D., Kerns, C., & Ellman, L. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.02.020 · Cited by 69
“Adapting current treatments to reduce stress sensitivity or emotional dysregulationmay prove useful in the treatment of those at risk for psychosis or those experiencing APPS (Pilling et al., 2002; Birchwood and Trower, 2006).”
Background
Clinical Social Work and the Biomedical Industrial Complex
Gomory, T., Wong, S. E., Cohen, D., & Lacasse, J. R. (2011) · The Journal of Sociology & Social Welfare · doi:10.15453/0191-5096.3635 · Cited by 69
“For example, a more recent meta-analysis of CBT applied to clients with a schizophrenia diagnosis (Lynch, Laws, & McKenna, 2010) found results contradicting Pilling et al. (2002) and Wykes et al. (2008).”
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The transmission of risk to children from mothers with schizophrenia: A developmental psychopathology model
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Psychoeducation in Mental Health
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“schizophrenia (Pilling et al., 2002).”
Adolescent-onset psychosis: prevalence, needs and service provision
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Effective elements of cognitive behaviour therapy for psychosis: results of a novel type of subgroup analysis based on principal stratification
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Self-citation
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Harvey, C. A., & O’Hanlon, B. (2013) · Australian & New Zealand Journal of Psychiatry · doi:10.1177/0004867413476754 · Cited by 64
A trial of problem-solving by community mental health nurses for anxiety, depression and life difficulties among general practice patients. The CPN-GP study
Kendrick, T., Simons, L., Mynors‐Wallis, L., Gray, A. R., Lathlean, J., Pickering, R. M., Harris, S., Rivero‐Arias, O., Gerard, K., & Thompson, C. V. (2005) · Health Technology Assessment · doi:10.3310/hta9370 · Cited by 64
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“By way of comparison trials of effective family-based interventions for the prevention of relapse in schizophrenia have entailed 9 months of therapy and longer in some studies.(34) A previously published individual CBT therapy for the prevention of relapse in schizophrenia included ongoing monitoring of early warnings…”
Method
Randomized controlled multicentre trial of cognitive behaviour therapy in the early initial prodromal state: effects on social adjustment post treatment
Bechdolf, A., Wagner, M., Veith, V., Ruhrmann, S., Pukrop, R., Brockhaus‐Dumke, A., Berning, J., Stamm, E., Janssen, B., Decker, P., et al. (2007) · Early Intervention in Psychiatry · doi:10.1111/j.1751-7893.2007.00013.x · Cited by 61
Profession Differences in Family Focused Practice in the Adult Mental Health System
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“Recent meta-analyses have concluded that CT is an effective treatment for persistent psychotic symptoms, that the effects of CT are robust over time and that drop-out rates are low (10, 11).”
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Attributional Style in Delusional Patients: A Comparison of Remitted Paranoid, Remitted Nonparanoid, and Current Paranoid Patients With Nonpsychiatric Controls
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Randomized Comparison of Group Cognitive Behaviour Therapy and Group Psychoeducation in Acute Patients with Schizophrenia: Effects on Subjective Quality of Life
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“An increasing number of successful clinical trials indicates that such interventions can aid to symptom reduction [34, 51, 53], relapse prevention [3, 6, 21, 24, 30], and improvement of social functioning [7, 50].”
Background
Hallucination focused integrative treatment improves quality of life in schizophrenia patients
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Developing family‐inclusive mainstream mental health services
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Self-citation
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Background
Recent approaches to psychological interventions for people at risk of psychosis
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Hallucination Focused Integrative Treatment: A Randomized Controlled Trial
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Authors: PILLING, S., BEBBINGTON, P., KUIPERS, E., GARETY, P., GEDDES, J., ORBACH, G., & MORGAN, C.
Affiliations: St Thomas' Hospital (GB)
ORCID: PILLING, S.
BEBBINGTON, P.
KUIPERS, E.
GARETY, P.
GEDDES, J.
MORGAN, C.
Venue: Psychological Medicine
Publisher: Cambridge University Press (CUP)
Published: 2002-07
Volume: 32
Issue: 5
Pages: 763-782
ISSN: 0033-2917 (ISSN-L)
1469-8978
DOI: 10.1017/s0033291702005895
OpenAlex: W2160436994
Cited by: 887
References: 62
Citations by year: 2026: 8 · 2025: 10 · 2024: 8 · 2023: 13 · 2022: 10 · 2021: 52 · 2020: 29 · 2019: 24 · 2018: 17 · 2017: 20 · 2016: 32 · 2015: 25 · 2014: 37 · 2013: 41 · 2012: 55
FWCI: 8.31
Type: journal article
Language: en
Open access: green
discovery.ucl.ac.uk
Licence: www.cambridge.org/core/terms (unspecified, 45 d)
Locations: Psychological Medicine (publishedVersion)
PubMed (publishedVersion)
UCL Discovery (University College London) (submittedVersion)
Research Portal (King's College London) (submittedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Social Sciences › Psychology › Clinical Psychology › Counseling, Therapy, and Family Dynamics
Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords: schizophrenia, family intervention, family therapy, cognitive behavioral therapy, social skills training, cognitive remediation, psychotic relapse, hospital readmission, medication adherence, treatment discontinuation, caregivers, treatment-resistant symptoms
MeSH terms: Adolescent, Adult, Family Therapy, Humans, Male, Middle Aged, Outcome and Process Assessment, Health Care, Schizophrenia, Schizophrenic Psychology, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic

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. Psychological treatments in schizophrenia: I. meta-analysis of family intervention and cognitive behaviour therapy.

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