Evidence of Treatment Efficacy and Effectiveness

It is now generally accepted that optimal management of schizophrenia requires a comprehensive approach com-bining pharmacologic management with psychosocial interventions (1). One of the most exciting developments in the last decade is the body of work indicating that cognitive-behavioural therapy (CBT) adds to treatment efficacy in schizophrenia. Much of the controlled research has been done on treatment-resistant patients with chronic schizophrenia, with CBT interventions modified for psy-chosis added to usual pharmacologic and case manage-ment. In this research, patients receiving CBT exper-ienced greater improvement of positive symptoms, negative symptoms and distress than did patients in treatment-as-usual or comparison conditions (2–10). Rec-tor and Beck (11) found effect sizes on positive symptom