The American Psychiatric Association practice guidelines for schizophrenia: Scientific base and relevance for behavior therapy

The American Psychiatric Association's practice guidelines for schizophreni a provide a general blueprint for treating people with the illness. They ar e primarily oriented toward psychiatrists and pharmacological management. H owever, the guidelines also discuss the importance of psychosocial treatmen ts, including behavioral therapy techniques. We provide an overview of the treatment guidelines and their empirical base. The pharmacological recommen dations are generally consonant with the literature, albeit they have becom e somewhat dated due to the rapid progress in studies of the effects of new generation antipsychotics. We next review recommendations concerning socia l skills training, cognitive therapy and rehabilitation. behavioral family therapy, and vocational rehabilitation. Overall, the guidelines are quite p ositive about the potential benefit of these interventions, but they are ap propriately conservative in interpreting the literature. There are promisin g data to support the efficacy of each of these approaches, but effectivene ss data are lacking and questions remain about their actual impact on commu nity functioning. Schizophrenia has not received sufficient attention from behavior therapists since the early successes achieved by operant programs. The optimistic stance taken by the guidelines should, if anything, encoura ge students to pursue careers working with this very needy population.