This project demonstrates 1) the feasibility of recruiting
older patients with schizophrenia to participate
in therapy group; 2) the active participation of members
in cognitive and skills-building activities in and out of
group; and 3) good treatment adherence by a majority
of participants.
Nonetheless, several caveats are in order. Although
some participants filled out the SDS at both pre- and
post-treatment, we did not report statistical analyses because
of the small sample size and uncertain reliability
of the measure. In future studies, investigators should
use interview- and observation-based assessments of
functioning and symptom change to assess the impact
of treatment, particularly since patients with schizophrenia
may not provide reliable responses on self-report
instruments.
There are limits to the intervention as developed,
as well. The intervention tested is quite brief. Previous
studies have involved interventions that lasted several
months to years, and in future studies it will be necessary
to address the length of treatment necessary to effect
change. The current intervention allowed little time
for repeated practice of each skill learned in session, and
lower-functioning patients in particular may need more
in-class training. Also, the use of a group format may
be difficult for some patients. The patient who missed
the most sessions had difficulty with paranoia, which
may have been exacerbated in the group setting. It may
be important to have individual therapy available for
some patients.