A study in the February issue of the Archives of General Psychiatry revealed that specially adapted cognitive therapy improved global function, motivation, and positive symptoms in people with schizophrenia who had a low-functioning status and significant cognitive impairment.
In the clinical trial, a control group of 29 patients received standard outpatient treatment and an experimental group of 31 patients received a novel form of cognitive therapy for 18 months. Standard treatment involved antipsychotic medication, case management, supportive counseling, day treatment services, housing services, peer support and vocational rehabilitation offered by community providers.
The novel form of cognitive therapy had the goal of awakening the patients' interest in and motivation to achieve easy, short-term goals, and also long-term goals like obtaining independent housing or employment. The goals all focused on drawing the individuals out of their isolated state.
PhD- and MD-level clinicians administered the cognitive therapy in weekly 50-minute sessions whose duration and frequency were flexible and tailored to the individuals' needs and progress. The mean age of the participants was 38 years and the mean duration of schizophrenia was 15 years. A significant number of them had residual positive symptoms like hallucinations, delusions, and disorganized thinking. They had neurocognitive impairments with information processing on tasks of memory, attention and executive function.
The results were detailed in Arch. Gen. Psychiatry 2012;69:121-7. Improvement on the 100-point Global Assessment of Functioning Scale was seen only in the subjects who received cognitive therapy. This set of participants showed significantly greater improvement than the control group on the avolition-apathy subscale of the Scale for the Assessment of Negative Symptoms, and greater improvement on the total score of the Scale for Assessment of Positive Symptoms.
The researchers hypothesize that cognitive therapy jump-starts the recovery process by "targeting self-defeating and dysfunctional beliefs that inhibit the patients' active engagement in constructive activity." This kind of therapy could reduce public health costs "for the most expensive per-patient psychiatric population while simultaneously improving patients' quality of life."
The study might have to be replicated because both the study participants and the clinicians were unblinded and aware of the experiment. This could introduce possible bias in reported outcomes.
Still, cognitive therapy as practiced by the brightest and most skilled providers in the field certainly holds the allure of 14kt gold, not pyrite because of its effective outcomes. I can vouch for this because I paid for 10 cognitive therapy sessions that changed my life for the better over the course of 10 weeks in the fall of 2007.
At the end of this SharePost, I will link to my other posts on the topic of cognitive therapy. The primary benefit of this kind of therapy is that you can reframe your thoughts, thus changing the outcome. I'm a big fan of cognitive therapy, also known as CBT.
Indeed, after I had the sessions, things changed over the years and their negative effect was minimal and I noticed a dramatic improvement. I would recommend cognitive therapy for anyone whose thoughts are stuck in a faulty loop and cause mental distress and overwhelming emotions. In its purest form, CBT can also help a person cope better with ongoing symptoms.
I'm certain cognitive therapy holds the greatest allure and the most significant hope for lasting benefits in the lives of people who have residual symptoms and a much harder time of it.
I'm such a big fan that I use my own, self-created cognitive therapy techniques in my life now that the sessions in the therapist's office have ended.
Published On: February 19, 2012