Brief psychological interventions for schizophrenia: a systematic review and meta-analysis

Although cognitive behavioral therapy for people diagnosed with schizophrenia (CBTp) is recommended in clinical guidelines internationally, rates of implementation are low. One consequence of this has been the development of brief individual psychological interventions, which are shorter than the recommended minimum of 16 sessions for CBTp. This article is the first to systematically identify the brief interventions that exist for people diagnosed with schizophrenia and to determine their effectiveness using meta-analysis.

Five electronic databases (PsycINFO, MEDLINE, CINAHL, EMBASE, and Web of Science) were searched for peer-reviewed randomized controlled trials or experimental studies of brief individual psychological interventions delivered in community settings. Random effects meta-analysis was used to integrate effect sizes, due to the heterogeneity of included studies.

Fourteen studies were identified (n = 1,382) that measured thirty clinical outcomes and included six intervention types - brief CBT, memory training, digital motivation support, reasoning training, psychoeducation, and virtual reality. Collectively, brief psychological interventions were found to be effective for psychotic symptoms (SMD -0.285, p < 0.01), paranoia (SMD -0.277, p < 0.05), data gathering (SMD 0.38, p < 0.01), depression (SMD -0.906, p < 0.05) and wellbeing (SMD 0.405, p < 0.01). For intervention types, brief CBT was effective for psychotic symptoms (SMD -0.32, p < .001), and reasoning training was effective for data gathering (SMD 0.38, p < 0.01).

Overall, the evidence suggests that brief psychological interventions are effective for several key difficulties associated with schizophrenia, providing an opportunity to improve both access to, and choice of, treatment for individuals diagnosed with schizophrenia.