Psychological Medicine

Review Article

Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation

S.  PILLING  a1 c1, P.  BEBBINGTON  a1, E.  KUIPERS  a1, P.  GARETY  a1, J.  GEDDES  a1, B.  MARTINDALE  a1, G.  ORBACH  a1 and C.  MORGAN  a1
a1 Centre for Outcomes, Research and Effectiveness, Department of Psychology, University College London, Department of Psychiatry and Behavioural Sciences, Royal Free and University College Medical School, Archway Campus, Department of Psychology, Institute of Psychiatry and Department of Psychiatry, St Thomas's Hospital, London; Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford; and John Connolly Unit, West London Health Care, Southall, Middlesex


Background. Social skills training and cognitive remediation are psychological techniques with considerable face validity for the treatment of negative symptoms of schizophrenia and their consequences. This paper provides a meta-analytical review of these treatments. It includes an appreciable number of randomized controlled trials, using comparisons against both standard care and other active interventions. However, the assessment of particular outcomes sometimes had to be based on single studies.

Method. A detailed search strategy was used to identify randomized controlled trials of social skills training and cognitive remediation, primarily employing electronic databases. Randomized controlled trials (RCTs) that met predefined criteria were then subjected to meta-analysis on a variety of outcome measures.

Results. There was no clear evidence for any benefits of social skills training on relapse rate, global adjustment, social functioning, quality of life or treatment compliance. Cognitive remediation had no benefit on attention, verbal memory, visual memory, planning, cognitive flexibility or mental state.

Conclusions. Social skills training and cognitive remediation do not appear to confer reliable benefits for patients with schizophrenia and cannot be recommended for clinical practice.

c1 Address for correspondence: Mr Steven Pilling, Centre for Outcomes, Research and Effectiveness (CORE), Department of Psychology, UCL, 1–19 Torrington Place, London WC1E 6BT.