Social Skills Training as a Nursing Intervention for Schizophrenia: A Randomized Control Trial

Running head: RESEARCH PROJECT
Task 2
Name of the Student
Name of the University
Author Note

1RESEARCH PROJECT
Introduction
The practice of nursing generally refers to a right that is granted by the state, with the
aim of protecting individuals who require care. Nursing professionals promote and provide
care services that most often involves service users, and their carers and family members in
the process of decision making, thereby facilitating the process of making informed choices
about the proposed treatment and care plan. The question regarding what establishes proper
nursing knowledge is crucial for nurses to consider due to several reasons (Cheraghi, Jasper
and Vaismoradi 2014).
Nurses are expected to use range of knowledge in their practice, including theoretical
and practical knowledge that helps them identify several interventions that should be central
to their practice (Westra et al. 2015). Schizophrenia is a major mental disorder, primarily
characterized by a range of psychotic symptoms where the affected individual often loses
touch with reality and suffers from perceptional impairments that affect the expression of
realities (Hüfner, Frajo-Apor and Hofer 2015). Nursing management of the condition
involves recognition of the disorder, establishment of support and rapport, maximization of
the patient’s level of functioning, assessment of the symptoms and medical history, followed
by conducting an evaluation. The research project will elaborate on increasing nursing
knowledge on a particular form of non-therapeutic intervention for schizophrenia.
Discussion
PICO question
This specialized framework is used for formulating a research question that facilitates
conduction of the literature review and adds to the body of knowledge. The PICO question
for the project was as follows:

2RESEARCH PROJECT
Do social skills training improve functioning in schizophrenia patients, when
compared to their usual standard treatment?
P (Population/problem) Schizophrenia patients
I (Intervention) Social skills training
C (Comparison) Usual care
O (Outcome) Improved functioning
Table 1: PICO framework
Literature review
Social skills training refers to a kind of psychotherapy approach that works with the
aim of aiding people to advance their social skills and competence. A single-blind
randomized controlled trial was conducted among veteran and non-veteran schizophrenia
consumers in an outpatient clinic and combined social skills training with cognitive
behavioural therapy in the intervention group (CBSST) (Granholm et al. 2013). Following the
36 week session of the therapy, significant positive results were obtained in the functional
trajectories of the patients, over time. The training program was also associated with better
improvements in the pessimistic attitudes of the patients. Similar findings were obtained in
another RCT that randomly assigned patients with schizophrenia and schizoaffective disorder
to a CBSST group and a control group (Granholm et al. 2014). Negative symptoms, defeatist
performance insolences, functionality, and amotivation were found to significantly improve
among the patients in the CBSST group. This indicates that social skills training, in
combination with CBT acted as an effective nursing intervention for improving the reduced
functioning and negative symptoms that are commonly reported by schizophrenia patients.
A preliminary study was also conducted with the aim of improving social competence
and functioning among patients suffering from schizophrenia (Rus-Calafell et al. 2013). 31

3RESEARCH PROJECT
patients were randomly assigned to the treatment group of social skills training and the
control group following which their post-intervention outcomes were assessed. The SST
patients reported improvements in their social discomfort, psychopathology, social
withdrawal, interpersonal communication and social cognition. Another study compared the
effects of computerized cognitive remediation, in combination with SST among
schizophrenic individuals (Kurtz et al. 2015). Upon comparing the outcome, the intervention
was found to bring about noteworthy advances in attention, empathy and working memory.
However, no significant differences were observed in psychosocial skills or functioning. The
feasibility and efficacy of a social training program, based on neuroplasticity was also
evaluated in another study (Nahum et al. 2014). Schizophrenia patients who completed the
online social program/game were found to demonstrate large improvements in their working
memory, social functioning and social cognition. Thus, this literature review provides
evidence regarding the effectiveness of social skills training programs and the need for
implementing it as a major form of nursing intervention to reduce schizophrenia related
symptoms.
Relevance of the topic
During psychotic episodes of schizophrenia, patients experience a plethora of positive
and negative symptoms. Some of the positive symptoms include hallucinations and delusions
that result in irrational or unusual behaviour (Langdon, Connors and Connaughton 2014).
Negative symptoms are those that result in anhedonia and the patients lose pleasure in
activities that were earlier pleasurable, and also report social withdrawal symptoms. Social
skills training (SST) have the primary objective of teaching individuals facing emotional
problems about certain non-verbal and verbal behaviour that are encompassed by social
interactions (Ottavi et al. 2013). SST is based on the prime assumption that when individuals
improve their change selected behaviour or social skills, they are found to enhance their self-