Training schizophrenics to talk to themselves: A means of developing attentional controls

Abstract

The efficacy of a self-instructional (SI) training procedure in altering the attention, thinking, and language behaviors of hospitalized schizophrenics was examined in two studies. Study I was an exploratory study designed to determine the feasibility of training schizophrenics to self-instruct (initially aloud and subsequently covertly) by means of cognitive modeling and cognitive rehearsal. The results of study I indicated that the SI group (N=5) improved relative to practice and assessment control groups on a digit symbol substitution task and on an auditory distraction digit recall task. Study II examined the therapeutic efficacy of extended individualized SI training (viz., 6 hr) in changing a range of behaviors. The SI training emphasized practice in monitoring intra- and interpersonal behaviors with a view to providing the schizophrenic with cues for emitting task-relevant self-statements. The results indicated that the SI group (N=5) relative to a yoked practice control group improved on a variety of measures including amount of “healthy talk” emitted in a structured interview, level of proverb abstraction, level of perceptual integration of responses to an inkblot test, and digit recall under distraction conditions. This consistent pattern of improvement for the schizophrenics who received SI training was evident in a 3-wk followup assessment. The treatment and research implications of directly modifying schizophrenics' cognitions are discussed.