Group Cognitive-behavioral Intervention for Social Anxiety in Schizophrenia
Condition: Social Anxiety; Schizophrenia
MeSH terms: Anxiety Disorders; Schizophrenia
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      This study will explore the helpfulness of a short psychological group treatment called
      cognitive-behavioral therapy, or CBT. CBT is a form of therapy that is very structured and it
      aims to improve difficulties that are related to behaviors and emotions by first working on
      identifying and changing negative inaccurate thoughts. The main goal of this intervention is
      to see if group CBT reduces the symptoms of social anxiety in people with schizophrenia so
      that they can improve their social functioning and help their psychotic symptoms. The study
      compares the usefulness of adding CBT to standard services.
    

Detailed description: 
      Social anxiety is highly prevalent in people with schizophrenia and represents a major
      obstacle to positive functional outcomes. Social anxiety is a treatable condition but has, in
      the context of psychosis, received only scant attention thus far. Current existing manualized
      treatment for social anxiety may not be optimal for people with schizophrenia for a number of
      reasons described above. An adapted CBT intervention for schizophrenia must target the stigma
      attached to the illness, the presence of poor social skills, the presence of delusional and
      persecutory ideas, possible limited reading abilities, and associated cognitive deficits. The
      investigators propose to develop and test an adapted group CBT for social anxiety. The main
      objective of this research proposal is to contrast the impact of a CBT intervention for the
      treatment of social anxiety in schizophrenia with standard care (care as usual) on reducing
      symptoms of social anxiety. Considering the relationship between certain characteristics of
      social anxiety (e.g. social withdrawal) with diminished quality of life and poor functional
      outcome, a secondary objective is to examine the impact of reduced social anxiety on
      functional outcome.
    

Intervention name(s): Cognitive-Behavioral Therapy based intervention immediately; Wait list
Intervention type(s): Behavioral; Behavioral
Intervention description(s): This intervention will include: i) Psychoeducation on social anxiety disorder; ii) Cognitive Restructuring: Identify negative thoughts that occur before, during, or after anxiety-provoking situations; Evaluate the accuracy of their thoughts in the light of data derived from Socratic questioning or as a result of so-called behavioral experiments; and derive rational alternative thoughts based on the acquired information; iii) Exposure component, which focuses on the collection of information that will allow patients to revise their judgments about the degree of risk to which they are exposed in feared situations, challenge their dysfunctional beliefs about the self relative to the illness and their self-efficacy (social status related), and iv) Use of Thought Records to identify, explore and dispute negative thoughts about dysfunctional self-identity and core beliefs related to the onset and presence of diagnosis of schizophrenia.; The group receiving treatment as usual (TAU) will be put on a wait list to receive the CBT intervention at the end of the experimental group, the one receiving the intervention immediately
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Remission; Psychosocial Functioning; Symptoms reduction