Social skills and Skills training
PATIENTS WITH SCHIZOPHRENIA usually lack social skills and have an inability to communicate effectively with people, confirm and express their feelings, and understand interpersonal boundaries. They may solve their problems in an unsuitable manner or they may have few solutions [Hoffmann et al 1998 and Lee and Chen 1991. S. Lee and B.C. Chen, Effects of social skill training on social functions of a schizophrenic patient in day care center: A controlled case study. The Journal of Nursing 38 (1991), pp. 43–51. View Record in Scopus | Cited By in Scopus (1)Lee and Chen 1991]. It is necessary to provide social skills training according to the state of illness of the patient with schizophrenia. This training encourages human interaction and is expected to improve the patient’s skills for conversation and assertiveness.
There were some limits in the design of past clinical studies. For example, there was no follow-up measurement after training [Chiang 1993, Hersen et al 1984 and Yang 1993], and factors that can influence social skills, such as gender, age, social and economic status, negative syndrome, interaction anxiousness, marital status, and so on, were not controlled and modulated during statistical analyses [Lee and Chen 1991 and Liberman et al 1986]. In this study, these limits were considered when designing social skills training for patients with schizophrenia. The effect of social skills training on patients with schizophrenia was compared between an experimental and control group. Measurements were taken at pretreatment, intratreatment, posttreatment, and follow-up, and the generalized estimating equation (GEE) mode of potentially influencing factors was applied during data analysis.
Literature review
Basic concept of social skills training
[Combs and Slaby 1977] defined social skills as the ability to interact with others in a social situation under circumstances and values accepted by society. [Rinn and Markle 1979] considered social skills to be verbal and nonverbal actions that influence the individual’s counterpart during their interaction. Integrating training plans from various scholars, social skills training can be divided into six skills: conversation, assertiveness, self-care, response interaction, conflict handling, and making friends. Social skills training typically includes conversation and assertiveness skills.
Conversation is a pathway to communicate with one another, and is both verbal and nonverbal. Conversation begins with a prologue of greeting, and includes a series of dialogues, questions, and answers until the conversation is finished. The tone, speed, cadence, and volume of speaking; posture; gesture; eye contact; body distance; facial expression; and proper wording all are part of the conversation. Therefore, conversation skill is usually an important component of social skills training [Cartledge and Kleefeld 1991, Lu 1995, Rinn and Markle 1979 and Walker et al 1983].
[Alberti and Emmons 1974] describe assertive skill as a behavior a person has when openly expressing ideas and opinions. Assertive skill includes the ability to refuse unreasonable demands from others, express positive and negative emotions, accept praise from others, express feelings to others, enjoy happiness with others, and express individual rage and dissatisfaction [Lu 1995 and Rinn and Markle 1979]. [Lazarus 1973] classified the assertive skill as having the ability to say no, ask for help from others, express positive and negative moods, and keep or end a general conversation. [Tseng 1999] regards assertive skills as the most correct and effective mode, but suggests that an individual would beat back others in a defensive manner because of a lack of learning and imitating opportunities during the process of individual growth.
Methods for training social skills
Although social skills training content will differ based on the counterpart, time, circumstance, and so on, the methods of training are similar. Integrating studies from various investigators, we divided training methods of social skills into five parts: explanation, demonstration, role-play, feedback and social enhancement, and a homework exercise. The leader develops simple circumstances and explains the problem that may be encountered and the skill to deal with it in advance of the training. Training uses video and audio media or a blackboard to assist oral expression, to help the patients see the action and learn [Liberman et al 1998]. Demonstration is used to show the patient the proper response to each situation to indicate proper behavior. The leader in a group or with the patient can play the demonstrator to teach the patient the proper response by exemplifying how to deal with a particular circumstance [Langewitz et al 1998 and Liberman et al 1998]. A patient and therapist are then selected to practice, or patients participate in a role-play and receive feedback [Marder et al 1996]. Feedback should be concrete and positive and give encouragement based on the patient’s practical behavior; feedback given immediately after the role-play has a greater effect [Liberman et al 1998]. Regardless of how well the patient interacts in the group, the patient must exercise this skill and routinely apply it in daily life [Lu 1995].
Factors influencing social skills training
Previous studies have shown that many factors can influence whether social skills training can advance the patient’s social abilities, such as whether the patient is participating in training, the values of the patient, the patient’s cultural background (e.g., language, method of communication; [Wilkinson and Canter 1986]), gender [Mueser et al 1995, Penn et al 1996, Perry et al 1995 and Wilkinson and Canter 1986], social and economic status [MacDonald et al 1998 and Wilkinson and Canter 1986], severe degree of negative syndrome [Kopelowicz et al 1997, Lysaker et al 1995 and Mueser et al 1995], and interaction anxiousness [Wilkinson and Canter 1986 and Yang 1998]. Among the factors, gender, social and economic status, negative syndrome, and interaction anxiousness have the most influence.
Tags: Social Skills