A controlled evaluation of systematic desensitisation and social skills training for socially inadequate psychiatric patients.

A controlled study of systematic desensitisation and social skills training was carried out on a sample of socially inadequate psychiatric patients. The results showed that both treatments led to significant improvements in the patients' social lives, which, in the case of social skills training were maintained at 6 months follow-up. Neither treatment, however, led to significantly greater anxiety reduction, improvements in social skills or clinical adjustment than the untreated control. Systematic desensitisation ran into a number of procedural difficulties and there was a substantial drop-out rate during treatment. Both treatments are discussed in the light of these mixed results and suggestions made for further research in this area.     

A systematic program to enhance clinician group skills in an inpatient psychiatric hospital

This article describes the collaborative effort of a team of discipline directors, administrators, and academicians to create a systematic program to enhance the group competencies of a large clinical staff working at a state hospital. The effects of the program were tested by a quasi-experimental field study. Quantitative measures of group process provided limited support for program effectiveness. Stronger support came from qualitative inquiry. The development and effectiveness of the program is examined within a larger context of group programs housed in large health care organizations.     

Exposure in vivo vs social skills training for social phobia: long-term outcome and differential effects

This study examined the long-term effectiveness of specific exposure in vivo (individual IE or group GE) and of office-based social skills training (group SST) in two groups of patients with social inhibition (primary social skills deficits or primary social phobia). Seventy-eight outpatients were divided into these two subgroups according to clinical assessment. Twenty-seven patients received SST which consisted of 25 twice a week 90-min group sessions: 32 patients received GE and 17 IE. Exposure in vivo consisted of 4 weekly (8-hr in the group condition included 2 hr discussion; 3 hr in the individual condition included 1 hr discussion) sessions. Self-rating-assessments were carried out at pre- and post-treatment, at 3 months- and 2.5 yr follow-up. The general results indicate that all three treatment modes led to clinically and statistically-significant improvements in the main problem area (social anxiety, skills deficits), in other neurotic complaints (depression, obsessions, psychosomatic complaints) and in attribution-style. Patients with the diagnosis of primary phobia seemed to get the same profit from either treatment and showed slightly better gains (in all treatment modalities) than patients with skills deficits at long-term follow-up. Within the subgroup with skills deficits there was a tendency for superior outcome of group exposure. These results and recommendations for future research are discussed.     

Effectiveness of social skills training with children: A meta-analytic study

This meta-analytic study examined the relative effectiveness of three methods of social skills training with socially isolated children: coaching, interpersonal cognitive problem solving, and modelling. An exhaustive search of the published literature in the area produced a total of 43 studies that met stringent criteria for inclusion in the subsequent analysis. Social skills training produced significant improvements in children's levels of social interaction, sociometric status and cognitive problem solving abilities. No training technique produced a significantly greater improvement than either of the others. Isolated children showed larger increases in their levels of social interaction and sociometric status than non-isolate children. Multi-modal training programmes were recommended to capitalize on the independent therapeutic effects which derive from a number of different social skills training techniques.     

An evaluation of group therapy for adolescents using social skills training

The present study investigated the hypothesis that social skills training is more effective in increasing socially acceptable behaviour in adolescents than is a generalized or non-specific form of group therapy. Forty-two subjects were selected to participate in the study from among adolescents referred for group therapy at two youth guidance clinics in Brisbane, Australia. The 23 males and 19 females were randomly assigned to one of three treatment conditions: a social skills training group, a non-specific therapy group and a waiting-list-for-therapy (control) condition. All subjects were assessed before and after treatment on five measures of social skills. Subjects in the social skills training group showed significant improvements on three of these measures while the non-specific therapy and waiting-list control groups showed no specific changes on any of the measures.     

Cognitive changes associated with social skills training

Changes in locus of control and self-esteem during social skills training and at 6 month follow-up were investigated. Forty-four adolescent, male offenders were randomly assigned to a social skills training, attention-placebo, or no-treatment control procedure. The results showed that pre- to post-training increases in self-esteem were produced for both the social skills training and attention-placebo control groups, but not for the no-treatment control group. These increases did not continue during the follow-up phase; the social skills training group, which showed the greatest improvement during training, displayed a decrease in self- esteem during follow-up.The locus of control measures showed a statistically significant shift towards internality for the social skills training group during training, which was not found for the attention-placebo and no-treatment controls. During the follow-up phase, all three groups showed a statistically significant shift towards externality, suggesting a tendency for boys to view their behaviour and consequences as being under the control of chance factors or powerful others, during institutionalization. This effect was partly reversed during training for the social skills training group, but the effect was not long lasting. It seems therefore that social skills training is effective in producing an increase in self-esteem and a shift towards internal locus of control. These changes are, however, of short duration and the self-esteem shift may be the result of increased staff contact or other non-specific therapy factors.     

Conversational skills training with a chronically hospitalized psychiatric inpatient

While conversational skills training has been conducted with select psychiatric populations, it has rarely been used with severely debilitated inpatients. The purpose of this study was to use a multiple baseline design across conversational components to evaluate the effectiveness of a conversational skills training package to enhance the conversational repertoire of a severely impaired inpatient. Audiotaped conversations with a standard confederate were evaluated for the frequency of questions, self-disclosures, and reinforcing/acknowledging comments. Generalization probe conversations to novel partners were also obtained. Training effects were noted for the 3 conversational units. Mixed results were obtained for generalization and follow-up.     

Utility of cognitive-behavioral procedures for social skills training with children: A critical review

Thirty-three studies that have used cognitive-behavioral social skills training procedures were critically reviewed. These studies were classified under four broad categories: (a) modeling, (b) coaching, (c) treatment packages, and (d) social problem solving. Seven criteria were used to critically evaluate these studies: (a) subject characteristics, (b) treatment specification, (c) out come measures, (d) statistical analyses, (e) experimental design, (f) generalization, and (g) cost effectiveness.     

Role of social skills training in adolescents with social anxiety disorder

Background/Objective: Social skills training (SST) is frequently included in the treatment of social anxiety disorder (SAD) in both children and adolescents, although there is no empirical evidence to support it. Consequently, our objective is to study the role and effects of SST in the treatment of a sample of adolescents with SAD. Method: A total of 108 adolescents diagnosed with generalized social phobia were randomly assigned to two treatment conditions (with and without SST) and a control group waiting list (WLCG). The evaluation included self-report measures, observational tests and blind evaluators. Results: Both interventions significantly reduced the number of social situations feared/avoided with respect to the WLCG, which worsened. Likewise, both interventions were effective but the group with SST obtained better results in the post-test and follow-ups, as well as a lower dropout rate (6:1). Conclusions: The use of SST reduces the dropout rate of treated adolescents and increases the effectiveness of the Intervention Program for Adolescents with Social Phobia.     

Application of social skills training in a group of institutionalized aggressive elderly subjects

A social skills training program consisting of instructions, modeling, role playing, and feedback was carried out with a group of 6 verbally aggressive institutionalized elderly patients. Dependent measures included confirmed incidents of verbal aggressive behavior monitored across an ABAB design with a 5-month follow-up period. Results indicated that verbally aggressive behavior can be significantly decreased in a group-training setting and subsequently generalized to ward and other socialized behavior. Ancillary aspects of the study include the role of social reinforcement, participant modeling, and staff attitude, perception, and motivation. Implications for future research are discussed.     

Success and failure in social skills training: individual differences

Four psychiatric out-patients with social dificulties were treated by social skills training and related treatments in a series of controlled within-subject designs. In all cases treatment produced predicted changes in social skills but these changes were not always sufficient to produce more general clinical change, which sometimes seemed to be more closely related to extra-therapeutic environmental changes. Several different treatment strategies were necessary in addition to social skills training including relaxation training, videotaped feedback and directive advice, and this emphasized important differences between patients which affected the choice of therapy. Three out of four cases improved; one reacted adversely to treatment and dropped out. Reasons for this failure are discussed. The study as a whole indicates the need to look more closely at individual patients, both in planning individual treatment and carrying out evaluative research.