Group Behavioral Activation (GBA) Intervention for Patients with Schizophrenia in South Korea: A Pilot Investigation of Community Mental Health Setting

Background and Purpose:

As a chronic serious mental illness, schizophrenia has increasingly become a global burden. Therefore, any intervention to reduce it is essentially appropriate and cost-effective (Bhugra, 2005). Although some drug treatments have shown quite effective prognosis in preventing psychiatric symptoms such as hallucinations, delusions, and recurrence, they are still not sufficient for key pathologies of schizophrenia such as cognitive impairment and social dysfunction. In addition, most patients with schizophrenia dwelling in the community need some evidence-based psychosocial intervention programs that can supplement drug treatments because there are very few biological treatments for improving social and occupational functions, and family relationships among patients with schizophrenia. The study examined the experimental effectiveness of group behavioral activation (GBA) program implemented to assess whether it is effective to reduce various psychotic symptoms and social functions among schizophrenia patients or not.

Method:

The study used a randomized controlled pilot study design. The study’s participants were schizophrenic patients enrolled in a community mental health center (CMHC) in South Korea. Of the 35 eligible patients, 18 were randomly assigned to the experimental group and 17 to the control group. Patients in the experimental group participated in a 10-week-long group-focused program, which was composed of activities such as scheduling, mood charting, self-reflection etc. All participants were asked to answer demographic questionnaires and to report their various psychotic symptoms and psychological properties (depression, pleasure, subjective well-being) at baseline and after 10 weeks. Independent sample t-tests between experimental and control groups and analysis of covariances (ANCOVAs) were used to verify the effectiveness of the GBA program.

Results:

Experimental group participated in the GBA program significantly improved psychopathic symptoms compared to the control group (F=10.789, p<.01). The psychopathic symptoms such as positive symptoms (F=6.858, p<.05), negative symptoms (F=10.167, p<.01), and general psychopathology (F=6.938, p<.05) were all significantly different between the two groups at the posttest. In addition, the participants’ subjective well-being in experimental group was significantly improved (t=-2.161, p<.05). However, their levels of depression, motivation, and pleasure were not significantly different between the two groups at the posttest.

Conclusions and Implications:

The participants in the GBA program showed significant improvement in all positive symptoms, negative symptoms and general psychosis of schizophrenia patients. Their subjective well-being scores also indicated significant between group differences at the posttest when controlling for pretest scores. These results suggest that the GBA program may be a potential intervention as an evidence-based psychosocial intervention program available in community mental health centers (CMHCs). Therefore, the program can help patients with schizophrenia to both reduce their mental disorders and improve their qualities of life.