Cognitive-Behavioral Therapy in Veterans With Schizophrenia

This is a study comparing the benefits of two types of individual psychotherapy (cognitive-behavioral therapy for psychosis and supportive therapy) in outpatients with schizophrenia or schizoaffective disorder. Treatment lasts 6 months and there are multiple assessment points.

This is a randomized controlled trial comparing 6 months of participation in one of two active treatments, cognitive-behavior therapy for psychosis or supportive therapy. Assessments of clinical status and social functioning will be obtained at baseline, mid-treatment, end of treatment, and 6 month follow-up. We hypothesize that participation in the cognitive-behavioral therapy will lead to greater reductions in symptoms and improvements in social functioning.

• Schizophrenia
• Schizoaffective Disorder

• Other: supportive therapy
  approximately 20 sessions of manualized psychotherapy to promote a strong alliance between the therapist and the participant in order to provide a safe place to discuss issues pertaining to recovery
• Other: cognitive-behavioral therapy for psychosis
  approximately 20 sessions of individual manualized psychotherapy in which participants are taught to evaluate the data supporting beliefs that may interfere with recovery
  Other Name: cbt for psychosis

• Experimental: Arm 1
  approximately 20 sessions of individual manualized psychotherapy in which participants are taught to evaluate the data supporting beliefs that may interfere with recovery
  Intervention: Other: cognitive-behavioral therapy for psychosis
• Active Comparator: Arm 2
  approximately 20 sessions of manualized psychotherapy to promote a strong alliance between the therapist and the participant in order to provide a safe place to discuss issues pertaining to recovery
  Intervention: Other: supportive therapy

Inclusion Criteria:

outpatients with schizophrenia or schizoaffective disorder in proximity to the West Los Angeles VAMC at least one month since last hospitalization stable antipsychotic medication persisting psychotic symptoms with at least minimal distress competent to sign informed consent.

Exclusion Criteria:

in other individual psychotherapy presence of organic brain disease mental retardation or illness that would prohibit regular attendance in therapy substance dependence diagnosis in the past 6 months.