Some people who develop symptoms of schizophrenia experience full or partial recovery when they receive typical early intervention services. Others need more help. The stigma of a mental health condition, along with a host of negative emotions like fear and anxiety, can crush a young person’s motivation and cripple their attempts to transition back into social settings. Severe difficulties with interpersonal relationships, coupled with feelings of isolation and alienation, ultimately lead to long-term social disability and the status of someone who just doesn’t fit in with their community.1,2,3

Enter social recovery therapy (SRT), a cognitive-behavioral intervention developed to help improve social skills and confidence in adolescents and young adults with early symptoms of schizophrenia, which may include confusion, paranoia, distraction, trouble concentrating, and physical awkwardness, leading to poor grades at school, difficulties at work, and social withdrawal. Proponents of SRT say that social recovery-oriented cognitive-behavioral therapy, with early intervention, can help restore a more competent and motivated mental state in young people experiencing first-episode psychosis. This, in turn, may help prevent the early loss of social function, which often leads to a poor long-term outlook for anyone with schizophrenia. Experts say timing of social recovery interventions is crucial because motivation to change is higher in an early state of psychosis than in later stages of schizophrenia.1,2,3

Social recovery interventions help people adjust to work, education and leisure activities by teaching and allowing them to practice necessary social competence skills in a protective environment. These may include problem solving, improving verbal and nonverbal communication, learning to correctly interpret and respond to everyday social situations, and understanding and expressing appropriate emotions. SRT also helps diminish any feelings of anxiety or hopelessness that may interfere with social success. Patients work closely with therapists to set personal social goals, then link those goals to related agencies and activities, such as job counselors, educational organizations, and community groups that organize or sponsor social activities. At the same time, cognitive behavioral therapy helps battle the harmful emotions that interfere with the ability to participate in new activities.1,2,3

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In the past, a lack of research, and therefore, a lack of evidence, created some debate among professionals as to the true value of SRT as a treatment for people with schizophrenia. Early studies indicate, however, that SRT is a promising intervention that appears to be well received by patients and that may help diminish the personal consequences of the functional disability associated with schizophrenia.4

One nine-month study of 155 young adults (ages 16 to 35) with first-episode psychosis found that those who received SRT with early intervention spent eight hours a week more on structured activities than those who did not receive SRT. They were able to better engage in normal activities like housework, schoolwork, chores, child care, paid and volunteer work, sports and other social activities.5 Ongoing research is helping to determine the long-term effects of social recovery therapy on people with schizophrenia whose needs are not met by conventional early intervention practices.

If you or someone you know is experiencing first signs of psychosis, such as hearing a voice or sensing suspicious feelings that are not connected to any reality, it is most important to seek help immediately from a primary care physician, psychotherapist or emergency room physician. You can ask your health care provider for a referral to a cognitive-behavioral therapist who is familiar with early interventions and has experience supporting young people with first-episode psychosis.

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Last Updated: May 13, 2021