Center for Psychiatric Rehabilitation, Department of Occupational Therapy, Boston University, Boston, Massachusetts 02115, USA.
Annu Rev Clin Psychol. 2013;9:465-97. doi: 10.1146/annurev-clinpsy-050212-185620. Epub 2013 Jan 16.
The current state of the literature regarding psychosocial treatments for schizophrenia is reviewed within the frameworks of the recovery model of mental health and the expanded stress-vulnerability model. Interventions targeting specific domains of functioning, age groups, stages of illness, and human service system gaps are classified as evidence-based practices or promising practices according to the extent to which their efficacy is currently supported by meta-analyses and individual randomized controlled trials (RCTs). Evidence-based practices include assertive community treatment (ACT), cognitive behavior therapy (CBT) for psychosis, cognitive remediation, family psychoeducation, illness self-management training, social skills training, and supported employment. Promising practices include cognitive adaptive therapy, CBT for posttraumatic stress disorder, first-episode psychosis intervention, healthy lifestyle interventions, integrated treatment for co-occurring disorders, interventions targeting older individuals, peer support services, physical disease management, prodromal stage intervention, social cognition training, supported education, and supported housing. Implications and future directions are discussed.
在心理健康恢复模型和扩展的应激易损性模型框架内,回顾了关于精神分裂症的心理社会治疗的现有文献。根据荟萃分析和个体随机对照试验(RCT)目前对其疗效的支持程度,针对特定功能领域、年龄组、疾病阶段和人类服务系统差距的干预措施被归类为基于证据的实践或有前途的实践。基于证据的实践包括:主张社区治疗(ACT)、精神病的认知行为疗法(CBT)、认知矫正、家庭心理教育、疾病自我管理训练、社交技能训练和支持性就业。有前途的实践包括:认知适应性疗法、创伤后应激障碍的 CBT、首发精神病干预、健康生活方式干预、共病障碍的综合治疗、针对老年人的干预、同伴支持服务、身体疾病管理、前驱阶段干预、社会认知训练、支持性教育和支持性住房。讨论了其影响和未来方向。