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Behaviour Therapy and Schizophrenia in Context: Challenges and Opportunities Provided within the Changing Mental Health System

Published online by Cambridge University Press:  06 October 2014

W. Kim Halford*
Affiliation:
Griffith Universityand Inner Brisbane North Mental Health Service
*
School of Applied Psychology, Griffith University, Nathan, Qld 4111, Australia
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Abstract

Research reported in the last two issues of Behaviour Change, and elsewhere, shows that cognitive behaviour therapy significantly improves a number of the problems suffered by people with schizophrenia. However, behaviour therapy alone does not constitute adequate care of schizophrenia, and inadequate mental health services undermine the effective implementation of behaviour therapy, in Australia, mental health services for people with severe psychiatric disorders such as schizophrenia are grossly inadequate, but are planned to change substantially in the late 1990s. Changes include a significant shift in resources toward community-based care, expansion of the range of treatment and rehabilitation services available, and increased integration of service provision across government and nongovernment sectors. These planned changes present a challenge to those interested in behaviour therapy to go beyond narrowly focused interventions to develop effective systems of rehabilitation.

Type
Research Article
Copyright
Copyright © The Author(s) 1995

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References

REFERENCES

Anthony, W.A. (1979). Principles of psychiatric rehabilitation. Baltimore: University Park Press.Google Scholar
Backer, T.E., Liberman, R.P., Kuehnel, T.G. (1986). Dissemination and adoption of innovative psychosocial interventions. Journal of Consulting and Clinical Psychology, 49, 460464.Google Scholar
Bellack, A.S., Morrison, R.L., Wixted, J.T., & Mueser, K.T. (1990). An analysis of social competence in schizophrenia. British Journal of Psychiatry, 156, 809818.CrossRefGoogle ScholarPubMed
Bellack, A.S., & Mueser, K.T. (1993). Psychosocial treatment for schizophrenia. Schizophrenia Bulletin, 19, 317336.CrossRefGoogle ScholarPubMed
Bentall, R.P., Haddock, G., & Slade, P.D. (1994). Cognitive behaviour therapy for persistent auditory hallucinations: From theory to therapy. Behavior Therapy, 25, 5166.Google Scholar
Benton, M.K., & Schroeder, H.E. (1990). Social skills training with schizophrenia: A meta-analytic evaluation. Journal of Consulting and Clinical Psychology, 58, 741747.Google Scholar
Birchwood, M. (1992). Early interventions in schizophrenia: Theoretical background and clinical strategies. British Journal of Clinical Psychology, 31, 257278.Google Scholar
Birchwood, M. (1995). Early intervention in psychotic relapse: Cognitive approaches to detection and management. Behaviour Change, 12, 219Google Scholar
Brooker, C., Tarrier, N., Barrowclough, C., Butterworth, A., & Goldberg, D. (1993). Training community psychiatric nurses for psychosocial interventions: Report of a pilot study. British Journal of Psychiatry, 160, 836844.Google Scholar
Burdekin, B. (1993). Human rights and mental illness: Report of the national inquiry. Canberra: Australian Government Publishing Service.Google Scholar
Doane, J.A., Goldstein, M.J., Miklowitz, D.J., & Falloon, I.R.H. (1986). The impact of individual and family treatment on the affective climate of families of schizophrenics. British Journal of Psychiatry, 148, 279287.Google Scholar
Eckman, T.A., Wirshing, W.C., Marder, S.R., Liberman, R.P., Johnston-Cronk, M.S., Zimmerman, K., & Mintz, J. (1992). Technique for training schizophrenic patients in illness self management: A controlled trial. American Journal of Psychiatry, 149, 15491555.Google Scholar
Edwards, J., Francey, S.M., McGorrey, P.D., & Jackson, H.J. (1994). Early psychosis intervention: Evolution of a specialised community-based specialised service. Behaviour Change, 12, 11, 223233.Google Scholar
Falloon, I.R.H., & Coverdale, J.H. (1995). Cognitive-behavioural family interventions for major mental disorders. Behaviour Change, 12, 11, 213222.Google Scholar
Falloon, I.R.H., & Fadden, G. (1993). Integrated mental health care. Cambridge: Cambridge University Press.Google Scholar
First National Mental Health Report 1993. (1994). Canberra: Australian Government Publishing Service.Google Scholar
Halford, W.K. (1994). Familial factors in psychiatry. Current Opinion in Psychiatry, 7, 186191.Google Scholar
Halford, W.K., Harrison, C., Kalyansundararam, , Moutrey, C., & Simpson, S. (in press) Rehabilitation of chronic psychiatric patients: Preliminary results from a comprehensive psychoeducational program. Hospital and Community Psychiatry.Google Scholar
Halford, W.K., & Hayes, R.L. (1991). Psychological rehabilitation of chronic schizophrenic patients: Recent findings on social skills training and family psychoeducation. Clinical Psychological Review, 11, 2344.Google Scholar
Halford, W.K., & Hayes, R.L. (in press). Social skill in schizophrenia: Assessing the relationship between social skills, psychopathology and community functioning. Social Psychiatry and Psychiatric Epidemiology.Google Scholar
Hayes, R.L., & Halford, W.K. (1993). Generalisation of occupational therapy effects in psychiatric rehabilitation. American Journal of Occupational Therapy, 47, 161167.Google Scholar
Hayes, R.L., Halford, W.K., & Varghese, F.N. (in press). Effects of social skills training on negative symptoms and community functioning of schizophrenic patients. Behavior Therapy.Google Scholar
Hogarty, G.E., Anderson, C.M., Reiss, D.J., Kornblith, S.J., Greenwald, D.P., Ulrich, R.F., & Carter, M. (1991). Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia: II. Two-year effects of a controlled study on relapse and adjustment. Archives of General Psychiatry, 48, 340347.Google Scholar
Hoult, J. (1994). Care of the seriously mentally ill in Australia. North Fitzroy, VIC: Schizophrenia Australia Foundation.Google Scholar
Hoult, J., Reynolds, I., Charbonneau-Powis, M., Weekes P., & Briggs, J. (1983). Psychiatric hospital versus community treatment: The results of a randomised trial. Australian and New Zealand Journal of Psychiatry, 17, 160167.Google Scholar
Kavanagh, D.J. (1992). Recent developments in expressed emotion and schizophrenia. British Journal of Psychiatry, 160, 601620.Google Scholar
Kavanagh, D.J., Clark, D., Piatowksi, O., O'Halloran, P., Manicavasager, V., Rosen, A.S., & Tennant, C. (1993). Application of cognitive-behavioural family interventions for schizophrenia: What can the matter be? Australian Psychologist, 28, 18.CrossRefGoogle Scholar
Liberman, R.P. (1992). Handbook of psychiatric rehabilitation. New York: MacMillan.Google Scholar
Liberman, R.P., & Corrigan, P.W. (1993). Designing new psychosocial treatments for schizophrenia. Psychiatry, 56, 238759.Google Scholar
Liberman, R.P., Van Putten, T., Marshall, B.D., Mintz, J., Bowen, L., Kuehnel, T.G., Aravagiri, M., & Marder, S.R. (1994). Optimal drug and behavior therapy for treatment-refractory schizophrenic patients. American Journal of Psychiatry, 151, 756759.Google Scholar
Loebell, A.D., Liederman, J.A., Alvir, J.M., Geiser, S.H., & Szymanski, S.R. (1992). Duration of psychosis and outcome in first-episode schizophrenia. American Journal of Psychiatry, 149, 11831188.Google Scholar
McFarlane, W.R., Dunne, E., Lukens, E., Newmark, M., Mclaughlin-Toran, J., Deakin, S., & Horen, B. (1993). From research to clinical practice: Dissemination of New York State's Family Psychoeducation project. Hospital and Community Psychiatry, 44, 265270.Google Scholar
Mueser, K.T., Wallace, C.J., & Liberman, R.P. (1995). New developments in social skills training. Behaviour Change, 12, 3140.Google Scholar
Muijen, M., Marks, I.M., Connolly, J., Audini, B., & McNamee, G. (1992). The daily living program: Preliminary comparison of community versus hospital-based treatment for the seriously mentally ill facing emergency admission. British Journal of Psychiatry, 160, 379384.Google Scholar
National Mental Health Policy. (1992). Canberra: Australian Government Publishing Service.Google Scholar
Paul, G.L., & Lentz, R.J. (1977). Psychosocial treatment of chronic mental patients: Milieu versus social-learning programs. Cambridge, MA: Harvard University Press.Google Scholar
Payne, P.V., & Halford, W.K. (1990). Social skills training with chronic schizophrenic patients living in community settings. Behavioural Psychotherapy, 18, 4964.Google Scholar
Sartorius, N. (1992). Rehabilitation and quality of life. Hospital and Community Psychiatry, 43, 11801181.Google Scholar
Tarrier, N. (1993). Cognitive behaviour therapy and schizophrenia. Keynote Address to the 25th Annual Convention of the European Association for Behaviour Therapy. London, 09 1993.Google Scholar
Tarrier, N., Beckett, R., Harwood, S., Baker, A., Yusopoff, L., & Ugarteburu, I. (1993). A controlled trial of two cognitive behavioural methods of treating drug resistant residual psychotic symptoms in schizophrenic patients. British Journal of Psychiatry, 162, 524532.CrossRefGoogle ScholarPubMed
Tarrier, N., Barrowclough, C., Vaughan, C., Bamrah, J.S., Porceddu, K., Watts, S., & Freeman, H. (1988). The community management of schizophrenia: A controlled trial of a behavioral intervention with families to prevent relapse. British Journal of Psychiatry, 153, 532542.Google Scholar
Ustun, T.B., & Gater, R. (1994). Integrating mental health into primary care. Current Opinion in Psychiatry, 7, 173180.Google Scholar
Vaughan, K., Doyle, M., McConaghy, N., Blaszcynski, A., Fox, A., & Tarrier, N. (1992). The Sydney intervention trial: A controlled trail of relative's counselling to reduce schizophrenic relapse. Social Psychiatry and Psychiatric Epidemiology, 27, 1621.CrossRefGoogle Scholar
Warner, R. (1994a). Recovery from schizophrenia (2nd ed.). London: Routledge & Kegan Paul.Google Scholar
Warner, R. (1994b, 09). Recovery from schizophrenia: Economic and social influences. Invited address at the 3rd Annual Convention of the Australian and New Zealand Mental Health Services Association, Melbourne.Google Scholar
Winkler, R. (1985). Twenty years of token economies in psychiatric institutions: Some basic issues. Behaviour Change, 2, 111118.Google Scholar
Zastowny, T.R., Lehman, A.F., Cole, R.C., & Kane, C. (1992). Family management of schizophrenia: A comparison of behavioral and supportive family treatment. Psychiatric Quarterly, 63, 159186.Google Scholar