New Non-Drug Therapy Promising for People with Schizophrenia

 

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"'Curb' was so chock full of appropriate scenes that it just made more sense to focus on it?and I thought it was funny," Roberts said. "I see 'Curb' as being similar to some Woody Allen movies in its use of only vaguely scripted dialogue. I wanted to shoot for something that felt closer to patients' real lives, and less like a fictional movie."

Eventually, Roberts and Penn began writing and shooting their own skits.

"It was kind of difficult to come up with the situations," Roberts said. They ended up drawing from examples on TV shows, clinical experience and their own lives.

"Think of the last few days of your life," Roberts said. "Have there been social encounters that left you feeling kind of bad, frustrated, confused, guilty? We could likely build a SCIT skit out of that kernel."

It turned out that patients responded just as well to the homemade videos.

"I think we succeeded in capturing awkwardness and discomfort in a way that may not have been as comedic as the shows, but was probably more true to life," Roberts said. "Also, we were able to fashion our scenes to hit exactly the notes that we wanted. If Larry David called now and offered to let us use the show, we'd probably stick with our scripts."

The Patients Respond

Patients agree that they've been helped. One person who completed a SCIT intervention in North Carolina said, "I used to think people were laughing at me when I came into the room. Now I know they're not."

Another wrote in response to a survey, "SCIT has helped me become more effective in interpersonal interactions by teaching the difference between facts and guesses, helpful and harmful feelings, the importance of non-verbal communication (which is responsible for fully 70 percent of social interchange), and the necessity of recognizing the difference between thinking and knowing."

Alice Medalia, a clinical psychiatry professor, is implementing the new therapy at the Columbia University's Lieber Recovery and Rehabilitation Clinic for Psychotic Disorders, which opened in April.

"I have found that SCIT is very helpful for people whose cognitive skills have been improved and the next step is how are you going to use them," she said.

Medalia combines neurocognitive therapy with SCIT to help people gain the skills to make friends again and go back to work.

"SCIT is really very different because the focus is to help people develop skills to be able to function better in everyday life," said Medalia. She explained that people with severe psychological illnesses often stop developing social skills, in part because the illness may present itself during young adulthood.

The therapy is also being used at the Federation Employment and Guidance Service, Inc., a non-profit group that provides health-related services to New Yorkers.

"Our staff love it, our clients love it, we're getting a lot of people engaged in it," said Amy Dorin, senior vice president of behavioral health services at FEGS. "Clients keep coming to the groups and we feel it has the potential to really help people with social cues."

Hope for Autistic Teens

After an eye-opening experience last summer where Penn observed a group for people with autism, he is now adapting SCIT for high-functioning autistic adolescents. He plans to use a separate set of videos to address situations focused more on emotions rather than paranoia.