Effectiveness of Group Cognitive Behavioral Therapy in Insight and Treatment Adherence in Schizophrenic Patients: A Randomized Controlled Trial

Abstract

Background: The rate of treatment adherence in patients with schizophrenia is lower than average, and they have insufficient insight in this regard. Objectives: The present study was designed to assess the effectiveness of group cognitive behavioral therapy (GCBT) in the improvement of insight and treatment adherence in schizophrenic patients. Methods: In this randomized controlled trial, accomplished in Shiraz Psychiatric Hospital, Shiraz, Iran, from October 2021 to January 2022, 22 eligible participants were assigned to either intervention, therapist’s attention placebo, and control groups via simple randomization. In the intervention group, a treatment program was performed in seven 90-minute sessions based on a treatment protocol adapted from Robert Paul Lieberman’s 16-session community return program. The therapist’s placebo group also watched documentaries for seven sessions. The control group received only their usual treatments, which included a visit to a psychiatrist. The data were gathered using the Insight and Treatment Attitudes Questionnaire and the Medication Adherence Rating Scale at three different time points. Results: At baseline, the mean scores of insight and medication adherence were not significantly different between all the groups. After the intervention, the results showed significant differences in insight levels (P = 0.001) and medication adherence (P = 0.003). Three months after the intervention, the results showed significant differences in insight levels and medication adherence (P = 0.001). The differences in the mean scores of insight levels and medication adherence in post-intervention and 3-month follow-up were only significant in the intervention group (P = 0.001). Conclusions: Based on the evidence from this study, GCBT is an effective treatment for improving insight and medication adherence in schizophrenic patients. Therefore, it is necessary to pay attention to the use of GCBT to increase compliance with drug treatment.