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Functional Adaptation Skills Training (FAST)

A Pilot Psychosocial Intervention Study in Middle-Aged and Older Patients With Chronic Psychotic Disorders

Received June 24, 2002; revised June 28, 2002; accepted September 6, 2002. From the University of California, San Diego, and the VA San Diego Healthcare System. Address correspondence to Dr. Patterson, Department of Psychiatry (0680), University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680. e-mail: tpatterson{at}ucsd.edu

OBJECTIVE: Developing behavioral interventions to improve functioning of older patients with schizophrenia and other chronic psychoses has the potential to significantly increase the patients' independence and quality of life. METHODS: The authors evaluated a psychosocial intervention designed to improve everyday living skills of middle-aged and older outpatients with very chronic psychotic disorders (mean duration of illness: 21 years). Forty patients who resided in board-and-care facilities were randomly assigned to either a 24-session functional adaptation skills training (FAST) group therapy program targeting problem areas identified in previous work as being problematic for this population (e.g., using public transportation) or treatment-as-usual. Almost all the participants also received antipsychotics. RESULTS: Compared with the patients randomized to the treatment-as-usual condition, FAST-treated patients' performance on everyday living skills improved significantly immediately post-intervention and was still significantly better at a 3-month maintenance follow-up period. There was no significant change in psychopathology. CONCLUSION: Results suggest that older patients with longstanding psychotic disorders may benefit from participation in this skills-training program.

Key Words: Schizophrenia Spectrum Disorder • Psychotherapies • Cognitive Therapy

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