Disease Management in Latinos With Schizophrenia: A Family-Assisted, Skills Training Approach

This study evaluated the effectiveness of a skills train-ing program designed to teach disease management to Latinos with schizophrenia treated at a community mental health center. Ninety-two Latino outpatients with schizophrenia and their designated relatives were randomly assigned to 3 months of skills training (ST) versus customary outpatient care (CC) and followed for a total of 9 months. The skills training approach was culturally adapted mainly by including the active par-ticipation of key relatives to facilitate acquisition and generalization of disease management skills into the patients ' natural environment. There was a significant advantage for the ST group over the CC group on sev-eral symptom measures, skill acquisition and general-ization, level of functioning, and rates of rehospitaliza-tion. There were no significant differences between the groups on quality of life or caregiver burden. Skills training had a direct effect on skill acquisition and gen-eralization, and utilization of disease management skills led to decreased rates of rehospitalization. Incorporat-ing an intensive, culturally relevant generalization effort into skills training for Latinos with schizophrenia appeared to be effective in teaching disease manage-ment and viable in a community mental health center