Original Title: Psicoterapias de grupo como técnica terapéutica en personas con esquizofrenia

Authors' objectives: 1. To conduct a systematic review of the literature to analyze the efficacy and effectiveness of group therapies and therapeutic strategies for patients with schizophrenia and to collect information about the associated therapeutic factors. 2. To conduct a systematic review of group strategies for patients with schizophrenia. To establish differences among group therapy modalities as well as differences among group therapy vs individual therapy.

Authors' results and conclusions: RESULTS: A total of 2751 references without duplicates were found in the electronic databases. After a review, 571 abstracts were selected, and 181 of these were reviewed exhaustively. A total of 69 papers were included. Two more randomized controlled trials were found manually. Thus, a total of 71 ítems were included: 12 systematic reviews; 28 articles of randomized clinical trials that were ultimately 22 clinical trials because some articles considered the same study, 23 non-randomized controlled studies, and 8 articles of observational that eventually were 7 observational studies because two articles related to the same study (Rico 2000, 2001). Results relating to randomized control trials and systematic reviews are exposed and discussed in detail. The 22 reviewed randomized clinical trials included three different types of group psychotherapy: Cognitive Behaviour Therapy (CBT), Social Skills Training (SST), and Integrated Psychological Therapy (IPT) for Schizophrenia. Ten of the clinical trials described results regarding CBT, eight about the SST and four about the IPT technique. Results are explained following these group classifications. CBT trials rest their efficacy in secondary results’ measures such as hopelessness, depression and self-esteem as well as the users' satisfaction level with the therapeutic procedures. However, CBT is not shown to be effective in the short term patients’ hallucinatory or delusional experiences. In his study published in the year 2000, Halperin found benefits in anxiety and social phobia and in 2005, Wykes found them in social behaviour. SST interventions obtain positive results in some measurements of social functioning, although some doubts arise when extrapolating these results to patients’ daily life. Clearly, the results obtained in the social skills training do not correlate with patients’ previous psychopathology or with its short-term improvement. IPT interventions are the third most used modality found in this review. Results suggest the limitations regarding the extrapolation of these benefits outside of the experimental context. Vallina (2001, 1998) used a multimodal intervention that provided positive achievements in all measured variables although he did not specify the contribution of each components of the program to the overall results and no cost study was performed. CONCLUSIONS: The achievements obtained in the group context and in the combined therapies regarding the patient's well being, quality of life, selfunderstanding, improvement of self-esteem, overcoming withdrawal, capacity to communicate, capacity to accept, admit and reveal their psychotic experiences, and to overcome hopelessness inspire the development of these group therapy practices and future research on their long-term effects on the psychotic experiences. Unilateral and fatalistic views of these disorders are associated to low levels of health care and low level of professional dedication. Currently, better quality in the treatment can be offered, this being a necessary and priority objective. Furthermore, it is necessary to develop future trials including: better methodology, homogenous groups of participants (therapeutic requirements), an adequate representation by gender and age, specialized therapists, and active control. Furthermore, improvement criteria on social functioning and patients’ quality of life should be better defined using appropriate and reliable measurement tools. As emphasized in the scientific literature of recent years, it is important to carry out these therapies within an individual daily life setting using longterm interdisciplinary community interventions that incorporate reinforcements of the acquisitions obtained.

Project Status: Completed

Year Published: 2010

URL for published report: https://sescs.es/psicoterapias-de-grupo-como-tecnica-terapeutica-en-personas-con-esquizofrenia/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Spain

Organisation Name: Canary Health Service

Contact Address: Dirección del Servicio. Servicio Canario de la Salud, Camino Candelaria 44, 1ª planta, 38109 El Rosario, Santa Cruz de Tenerife

Contact Name: sescs@sescs.es

Contact Email: sescs@sescs.es