Group therapies for schizophrenia: initial group climate predicts changes in negative symptoms

Abstract

Objectives: Whilst group therapies for schizophrenia are effective in reducing negative symptoms, little is known about the mechanisms that bring about these improvements. This study examined the association between group climate (perceived group environment) and negative symptom outcomes.

Method: Group climate was rated from eleven video-recorded outpatient therapy groups (N = 85), by three independent researchers blind to clinical outcomes. Multi-level linear modelling was used to explore the relationship between changes in negative symptom scores before and after group therapy, and group climate assessed at the first, second, third and fourth therapy stage.

Results: High group engagement, low conflict and low avoidance in the first therapy stage were associated with improvements in negative symptoms. Associations in the latter stages mainly failed to reach statistical significance.

Conclusion: Findings highlight the importance of initial group mechanisms in treating negative symptoms. Future research should explore how to promote optimal initial group conditions in the treatment of schizophrenia.

Keywords:

• Group therapy
• schizophrenia
• group process
• negative symptoms
• group climate