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.