A behavioural training programme for chronic schizophrenic patients. A three-month randomised controlled trial in Beijing

Abstract

This paper discusses the effectiveness of an in-patient rehabilitation programme administered by nurses that combines life skills training, active encouragement, and a token economy. Fifty-two chronic schizophrenic patients with prominent negative symptoms who had been continuously in hospital for at least a year were randomly assigned to the experimental or control group. The training and associated reinforcement schedule were administered daily to experimental subjects by two specially trained rehabilitation nurses. Control subjects did not receive training or reinforcement but were individually asked to perform the same daily tasks and participate in the same activities as the experimental-group subjects. Patients in both groups received their previous dosage of medication throughout the trial. After three months the severity of negative symptoms, as assessed by blind evaluators, decreased in both groups of subjects, but the improvement in the experimental group was much greater than that in the control group. These findings demonstrate the efficacy of behavioural interventions for chronic schizophrenic in-patients in China and highlight the importance of changing the role of Chinese psychiatric nurses from that of custodians who control patients' behaviour to that of therapists who provide psychological and behavioural treatment.