Outcome and Process Characteristics of a Psychoeducation­ al, Coping Oriented Group Therapy for Schizophrenia and Schizoaffective Patients

Fries, Alexander; Pfammatter, Mario; Andres, Karl; Brenner, Hans Dieter (2003). Outcome and Process Characteristics of a Psychoeducation­ al, Coping Oriented Group Therapy for Schizophrenia and Schizoaffective Patients. Verhaltenstherapie, 13, pp. 237-243. Karger

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Background: Psychoeducation is a core element in psycho­ logical therapy for schizophrenics. lts application has been intensively studied and weil established in the family set­ ting. Empirical data concerning its efficacy without involve­ ment of relatives are scarce. Patients and Methods: In a ran­ domized controlled trial, effects and process quality of a psychoeducational coping oriented group therapy for schiz­ ophrenia and schizoaffective patients were compared to those of a control group in which supportive discussions and training in problem solving were offered. Results: Both groups showed clear reductions in psychopathology and improved cognitive coping with the illness at completion of the therapy and at one-year follow-up. In addition, coping oriented therapy reduced relapse rates and days in hospital compared to the control group during the first year after therapy. Regarding process-outcorne-relations a good thera­ peutic relationship, as perceived by the patients, was asso­ ciated with the success of the psychoeducational, coping oriented intervention. In contrast, those patients of the sup­ portive therapy who dernonstrated the highest degree of psychopathology at the end of therapy, feit more comfort­ able in this treatment. Other assessments of the quality of the therapeutic process also revealed strong relations to the outcome at the end ot therapy. These relations varied be­ tween the two treatment groups. Discussion: On the one hand, our results indicate that the patients' ratings of the quality of the therapeutic relationship deterrnine the success of the psychoeducational, coping oriented therapy. On the other hand, patients with more persistent symptoms may prefer the less structured supportive therapy approach. Therefore, in future psychotherapy research with schizo­ phrenia patients it will be important to be more concerned with the formation of a good therapeutic relationship and to identify differential indication criteria to enhance the efficacy of psychological therapy approaches.

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