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. Psychological treatments in schizophrenia: I. meta-analysis of family intervention and cognitive behaviour therapy.
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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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“These findings are consistent with previous studies of acceptance and commitment therapy for psychosis.”
From Acceptance-based Behavior Therapy for Depression With Psychosis (2015) · cites this paper as [60]
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“A recent meta-analysis of mindfulness/acceptance interventions for psychosis showed that these treatments are most effective for distress related to psychosis and negative or affective symptoms.60,61”
From Acceptance-based Behavior Therapy for Depression With Psychosis (2015) · cites this paper as [60]
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“Much empirical research in psychosocial interventions for schizophrenia has shown that training in symptom handling, social proficiency training, and supportive provisions in occupational relations can help patients to function in their daily lives [38-47].”
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Cognitive therapy for persistent psychosis in schizophrenia: a case-controlled clinical trial
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“Cognitive Behavior Therapy (CBT) has shown considerable promise as a treatment for schizophrenia in numerous randomized controlled trials in the United Kingdom, (Sensky et al., 2000; Gould et al., 2001; Rector and Beck, 2001; Pilling et al., 2002).”
BackgroundUpdate on Cognitive Behavioral Psychotherapy for Schizophrenia: Review of Recent Studies
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“…sufficient evidence for treating psychotic and mood symptoms, reducing hospitalization, and reducing the disability associated with a schizophrenia spectrum disorders (Gould et al., 2001; McDonagh et al., 2018; Pilling et al., 2002; Turner et al., 2020; Wykes et al., 2008; Zimmermann et al., 2005).”
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“Family-based interventions have included structured problem-solving, and communication skills training aimed at lowering expression emotion (EE) (Falloon, 1988; Mueser & Glynn, 1999; Pilling et al., 2002) and multi-family interventions (McFarlane, Dixon, Lukens, & Lucksted, 2003).”
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“These treatments have been shown to be effective in alleviating the negative symptoms of schizophrenia 11,13 – 15 .”
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“Together, these two papers report more favourable outcomes of cognitive therapy in schizophrenia than those in some of the published meta-analyses [”
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“Although there are multiple approaches for family interventions in psychotic disorders, the core components are problem-solving skills, psychoeducation, and communication skills (4, 5).”
BackgroundMerging Evidence-Based Psychosocial Interventions in Schizophrenia
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“randomized controlled trials have been published to date supporting the effects of family psychoeducation on increased medication adherence, and decreased stress and symptoms in those receiving psychiatric care [15,22].”
BackgroundKnowledge of suicide history, current depressive symptoms, and future suicide risk within couples
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“Results from studies using these techniques have demonstrated reductions in positive symptoms, such as delusions and hallucinations, or reductions in stress caused by these symptoms, among patients motivated to participate in the treatment (Dickerson 2000; Pilling et al. 2002; Rector and Beck, 2002).”
Schizophrenia: Putting context in context
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Exploring the digital support needs of caregivers of people with serious mental illness
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“Glynn et al. [29] reported that an online psychoeducation program for multiple families of PSMI reduced relapse rates by up to 50%, consistent with other research conducted over the past two decades [63, 88, 90].”
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Surreptitious Prescribing in Psychiatric Practice
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“…favor— family interventions demonstrate more robust outcomes than any other form of psychosocial intervention for psychosis (Dixon et al., 2000; Pilling et al., 2002)—but this clearly requires a shared understanding of the problem, culturally appropriate methods of delivering targeted…”
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Abordagens psicoterápicas no transtorno bipolar
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An Evaluation of Well Ways, a Family Education Programme for Carers of People with a Mental Illness
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“Further, despite considerable empirical evidence to support their effi cacy [16], clinician-delivered family psycho-education programmes have had poor rates of dissemination in mental health services and specifi c training initiatives have had modest uptake by staff and services [17–19].”
BackgroundGleeson, J., Koval, P., Zyphur, M. J., Lederman, R., Herrman, H., Eleftheriadis, D., Bendall, S., Cotton, S., Gorelik, A., & Álvarez‐Jiménez, M. (2023) · Schizophrenia Research · doi:10.1016/j.schres.2023.03.019 · Cited by 21
James, C., Cushway, D., & Fadden, G. (2006) · Journal of Mental Health · doi:10.1080/09638230600700805 · Cited by 19
“Strong evidence exists to support the use of psychoeducational family interventions for schizophrenia (Pilling et al., 2002).”
BackgroundRichards, M. M., Doyle, M., & Cook, P. G. (2009) · The British Journal of Forensic Practice · doi:10.1108/14636646200900027 · Cited by 19
Best, M. W., Grossman, M., Milanovic, M., Renaud, S., & Bowie, C. R. (2018) · Psychosis · doi:10.1080/17522439.2018.1472630 · Cited by 19
“Meta-analyses of general cognitive therapy for psychosis support efficacy to improve positive symptoms (Pilling et al., 2002).”
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“Interventions aimed at improving social support from family and peers have previously been found to be effective amongst individuals who already have psychosis (Pilling et al ., 2002; Norman et al ., 2005; Castelein et al ., 2008).”
Clark, S. D., Snellenberg, J. X. V., Lawson, J. M., & Abi‐Dargham, A. (2020) · Neuropsychopharmacology · doi:10.1038/s41386-020-0730-z · Cited by 19
PSYCHOEDUCATION FOR PSYCHOTIC PATIENTS
Praško, J. P., Vrbová, K., Látalová, K., & Mainerová, B. (2011) · Biomedical Papers · doi:10.5507/bp.2011.008 · Cited by 20
Homework Use in Cognitive Therapy for Psychosis: A Case Formulation Approach
Rector, N. A. (2007) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2006.10.008 · Cited by 19
Why do schizophrenic patients hallucinate?
Roelfsema, P. R., & Supèr, H. (2003) · Behavioral and Brain Sciences · doi:10.1017/s0140525x03410029 · Cited by 18
A War of Nerves: Soldiers and Psychiatrists in the Twentieth Century
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Coping With Schizophrenia in Forensic Services
Absalom‐Hornby, V., Gooding, P. A., & Tarrier, N. (2011) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31821cd394 · Cited by 18
“…the success and evidence base of psychological interventions in general mental health, such as cognitive behavior therapy and family interventions for schizophrenia (Pilling et al., 2002), these therapies may be suitably adapted for the forensic population (Peddie, 2009; Richards et al., 2009).”
BackgroundVelligan, D. I., Draper, M., Stutes, D. S., Maples, N. J., Mintz, J., Tai, S., & Turkington, D. (2009) · Schizophrenia Bulletin · doi:10.1093/schbul/sbp075 · Cited by 18
Cognitive-behavioural therapy for schizophrenia in a forensic mental health setting
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“…with many types of individuals with psychosis, particularly with individual suffering from persistent psychotic symptoms (Gould & Mueser, 2001; Pilling et al., 2002) but also with inpatients (Drury, Birchwood, Cochrane, and Macmillan 1996), first episodes of psychosis (Lecomte, Leclerc,…”
BackgroundInternalized Stigma and Perceived Family Support in Acute Psychiatric In-Patient Units
Korkmaz, G., & Küçük, L. (2015) · Archives of Psychiatric Nursing · doi:10.1016/j.apnu.2015.10.003 · Cited by 18
“This study used the Perceived Social Support from Family Scale, which was developed by Procidano and Heller (1983) to measure the perceived social support from a patient's family, translated by Eskin (1993), and developed by Yıldırım et al.”
MethodCognitive behaviour therapy within acute mental health care: A critical appraisal
Munro, S., Baker, J. A., & Playle, J. F. (2005) · International Journal of Mental Health Nursing · doi:10.1111/j.1440-0979.2005.00365.x · Cited by 18
The future of psychological therapies for psychosis.
Garety, P. A. (2003) · PubMed · Cited by 18
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“To date, several family intervention programs have been developed and tested, with the following three elements identified as most promising and feasible: (1) psychoeducation for families to increase knowledge about schizophrenia and strengthen related caregiving skills; (2) peer-support for both family caregivers and…”
BackgroundBacil, R. P., Filho, E. A. D. O. M., Dias, K. D. A., Portes, M. C., de Araujo, W. R., Oliveira‐Silva, D., Santos, A. A. D., & Serrano, S. H. P. (2021) · Journal of Electroanalytical Chemistry · doi:10.1016/j.jelechem.2020.114946 · Cited by 17
Relatives' Criticism Influences Adjustment and Outcome After Traumatic Brain Injury
Weddell, R. A. (2010) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2010.01.020 · Cited by 18
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Changing Trends in Mental Health Care and Research in Ghana
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Pyle, M., Norrie, J. D., Schwannauer, M., Kingdon, D., Gumley, A. I., Turkington, D., Byrne, R. E., Syrett, S., MacLennan, G., Dudley, R. E. J., et al. (2016) · BMC Psychiatry · doi:10.1186/s12888-016-0983-6 · Cited by 17
“with several meta-analyses showing robust support for this approach [16–20].”
MethodLysaker, P. H., & Roe, D. (2012) · Journal of Psychotherapy Integration · doi:10.1037/a0029581 · Cited by 18
Pinninti, N. R., Fisher, J., Thompson, K., & Steer, R. A. (2009) · Community Mental Health Journal · doi:10.1007/s10597-009-9271-y · Cited by 16
“CBT remains an underutilized treatment modality for individuals with SMI, provided only by highly trained psychologists, social workers, nurse specialists, and few psychiatrists (Pilling et al. 2002).”
BackgroundSabancıoğulları, S., & Tel, H. (2015) · Neurosciences · doi:10.17712/nsj.2015.2.20140713 · Cited by 16
Schizophrenia Spectrum Disorders and Autism Spectrum Disorder
Chisholm, K., Lin, A. P., & Armando, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-29695-1_4 · Cited by 17
Metadata
- Authors
- PILLING, S., BEBBINGTON, P., KUIPERS, E., GARETY, P., GEDDES, J., ORBACH, G., & MORGAN, C.
- Affiliations
- St Thomas' Hospital (GB)
- 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
- 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
- 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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