By Annette M. Boyle

BALTIMORE-- For many veterans with schizophrenia, deficits in social skills commonly associated with the disorder can make maintaining relationships and achieving personal goals extremely challenging. The VA’s Social Skills Training (SST) program helps these veterans acquire the skills they need to effectively engage in social interactions, set and reach goals and take critical steps on the road to recovery.

Richard W. Goldberg, PhD

“The social skills training program makes evidence-based psychosocial treatment accessible to veterans with schizophrenia. Through the program, they learn how to communicate more effectively, integrate more actively into society and adopt roles and goals that relate to living a meaningful life,” said Richard W. Goldberg, PhD, director of the VA Psychosocial Rehabilitation Training Program at the VA Maryland Healthcare System in Baltimore and associate professor at the University of Maryland School of Medicine.

The VISN 5 Mental Illness Research, Education and Clinical Center (MIRECC) oversees implementation of social skills training programs across the VA health system. The program is co-facilitated by the VSIN 22 MIRECC in Los Angeles.

Since 2008, 465 clinicians and some peer-support technicians have gone through the two-day training and six-month follow-up consultation that enables them to establish and operate SST programs in sites across the country. As each clinician typically runs several groups of six to eight patients, hundreds of veterans have had the opportunity to participate.

Goldberg’s group provides ongoing consultation to clinicians to assist with implementing the programs in a variety of settings. Groups operate within Psychosocial Rehabilitation and Recovery Centers (PRRC), as well as inpatient and outpatient clinic settings.

“We help clinicians focus on getting buy-in from program directors and building SST into existing programming. Our ability to implement the training across the country speaks to the VA’s commitment from the top down to assure that veterans have access to effective treatments for schizophrenia,” Goldberg said.

Recovery Through New Ways of Interaction

“Recovery is possible, even after diagnosis of a severe mental illness such as schizophrenia,” said Goldberg. “Recovery is about skills and support for roles and goals. The SST program gives veterans the support and teaches them the skills they need to learn new ways of interacting with others and new approaches to life management.”

This approach is in keeping with the National Consensus Statement on Mental Health Recovery: “Mental-health recovery is a journey of healing and transformation enabling a person with a mental-health problem to live a meaningful life in a community of his or her choice while striving to achieve his or her full potential.”

A group-based behavioral intervention, SST teaches expressive and receptive skills, starting with listening and letting speakers know they are being heard. Through very structured role-play, group participants learn how to communicate their feelings, make requests, assert themselves, engage in conversation and manage conflict in the contexts of friendships, dating, vocational and work settings, health maintenance and alcohol- and drug-related challenges.