94. Enhancing the Functional Adaptation Skills Training Treatment for Individuals With Schizophrenia: A Treatment Comparison Study

Abstract

Background: Research has demonstrated that Functional Adaptation Skills Training (FAST; Patterson et al., 2006; Bowie et al, 2012) can enhance psychosocial functioning and improve quality of life for individuals with schizophrenia. Yet, research also suggests that the generalizability of this treatment to real-world daily functioning is limited. The purpose of the present study, therefore, was to see if the generalizability of FAST could be enhanced by including in-home-caregivers in the treatment and by utilizing Azjen's (1999) Theory of Planned Behavior (TPB) to foster motivation and enhance behavioral changes. Methods: A new treatment, known as Improving Recovery in Schizophrenia (IRIS), was developed and 41 medically stabilized individuals with schizophrenia who resided in board and care homes in the San Diego area were randomly assigned to receive either the IRIS or FAST treatment modality. Assessments were conducted at baseline, post-treatment (after 12 weeks) and follow-up (1 month following the treatment) time points. The frequency of 7 functional target behaviors were assessed by board and care staff members daily for all participants in the study. Results: Results indicated IRIS members improved signifcantly more than FAST members from baseline to follow-up on social self-effcacy, TPB control beliefs, symptom severity (general and total) and number of total behavioral attainments. IRIS members also improved signifcantly on TPB Intentions to conduct functional behaviors and self-effcacy related to negative symptoms. A moderating relationship indicated that IRIS mem-bers with high self-effcacy scores at baseline showed signifcantly more behavioral improvements than IRIS members with low baseline self-eff-cacy scores. FAST members showed signifcant changes only in functional capacity (as shown on a role-play task) but not in the frequency of real-world functioning behaviors or on any other measure addressed in the current study. Conclusion: The data suggest that the IRIS intervention may enhance the effcacy of the FAST treatment for facilitating changes in behavioral attainments, self-effcacy related to negative symptomatology and social activities, control beliefs, intentions toward completing functional behaviors and symptom management. These data also suggest that care-taker assistance, environmental reinforcements and self-effcacy play important roles in behavior change among individuals with schizophrenia.