Social Skills Training In Schizophrenia
I’m fortunate to have received a copy of Recovery from Disability: Manual of Psychiatric Rehabilitation. The author Robert Paul Liberman, MD pioneered the use of effective social skills training for individuals with mental illnesses in the 1970s.
The goal of social skills training is for the person to achieve personal goals and favorable responses from the social environment. To wit: “The rubber hits the road towards recovery.”
Each person’s definition of a “meaningful and satisfying” life and contribution to society is linked to his personal goals, needs, priorities, preferences and interests. As well, the values, family and cultural influences and the norms of society shape each person’s sense of satisfaction with life.
Social skills training directly enables individuals with mental disabilities to bring satisfaction and quality into their lives. It benefits individuals whose cognitive and other pre-morbid impairments have interfered with developing social skills.
This treatment is an asset model approach that builds on each person’s strengths instead of focusing on symptoms or psychopathology. It is not a standalone treatment and is used in conjunction with medication and psychoeducation and other strategies.
Social skills training involves real-life practice throughout the person’s life. The training is generalized from the treatment room to everyday interactions.
A typical approach uses the pathway of personal effectiveness to successful living:
You identify your personal goal (expressed as “How do you want your life to be different and better than now?”).
You select a situation involving another person that will be a small step toward reaching your goal. (You choose what you want to attain, with whom you need to communicate, where and when you will be trying to take this step.)
You watch a demonstration of the situation with another person taking your role. (To learn by watching the skills being used in the role-play.)
You practice the skills for achieving your needs in a role-play, using good verbal and nonverbal communication. (To learn by doing the skills in behavioral rehearsal with coaching and positive feedback.)
You give and get positive feedback for what you have done effectively. (Positive reinforcement strengthens your skills and know-how.)
You complete a homework assignment that enables you to use your skills in everyday life. (To use your personal effectiveness to make your life more successful and satisfying is where the rubber hits the road.)
The chapter on social skills training in Dr. Liberman’s manual goes into even greater detail and is great for use by professionals working in the mental health field. I also recommend mental health treatment staff buy the book and read it straight through to incorporate the techniques in their practice.
Social skills training is a specific type of training and is not to be confused with simply having patients interact with each other in a day program. The goals you set are S.M.A.R.T: specific, measurable, achievable, realistic and time-limited. The training has an outcome and doesn’t go on forever.
Social skills training also offers techniques for social problem-solving when you don’t get the desired result or you find yourself in an interpersonal situation that wasn’t reinforced in the treatment room.
Behavioral learning principles are the foundation of social skills training that aims to improve your interpersonal relationships and ability to negotiate getting your needs met and achieving goals.
You can find a private therapist that might use social skills training in his or her practice by using the therapist locator on the Association for Behavioral and Cognitive Therapies Web site.
In the coming months I will devote SharePosts to recovery strategies you can use in tandem with formal, structured sessions with professionals.
Keep an eye out for my news article on anosognosia: the hidden symptom as well as for information on a breakthrough concept in the mental health recovery movement.
I have SharePost topics hammered out to write that will carry us through fall 2014.
Christina Bruni wrote about schizophrenia for HealthCentral as a Patient Expert. She is a mental health activist and freelance journalist.