ArticleBMJ open2025
Scoping review mapping the implementation and adaptation of life skills training programmes for individuals with schizophrenia spectrum disorder: contexts, frameworks, interventions and outcomes.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo map the implementation and adaptation of life skills training programmes for individuals with schizophrenia spectrum disorder across diverse settings, identifying frameworks, intervention components, outcomes and implementation strategies.
designA scoping review following Arksey and O'Malley's methodology and Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews reporting guidelines. DATA SOURCES: Six electronic databases (MEDLINE (Ovid), PubMed (National Library of Medicine), PsycINFO (APA PsycNET), CINAHL (EBSCO), ThaiJo (Thai Journals Online) and TCI-Thailand (Thai-Journal Citation Index) were searched from 1970 to 10 December 2024, supplemented by handsearching reference lists and relevant organisational websites. ELIGIBILITY CRITERIA: Primary studies targeting life skills training for adults with schizophrenia spectrum disorder, including at least three life skills components (medication management, social skills, communication, organisation/planning, transportation, financial management) and providing intervention details. DATA EXTRACTION AND SYNTHESIS: Data were extracted using the Template for Intervention Description and Replication checklist. Outcomes were analysed using Kirkpatrick's four-level training evaluation framework. Implementation adaptation, barriers and enablers were identified through narrative synthesis.
results33 studies from 7 countries (France, Italy, Spain, Canada, USA, Turkey and China) met inclusion criteria. Three major programme frameworks emerged: University of California, Los Angeles Social and Independent Living Skills Programme, Functional Adaptation Skills Training and Cognitive-Behavioural Social Skills Training. Cultural adaptations were crucial for implementation success, with programmes demonstrating adaptability across diverse settings while maintaining core therapeutic components. Implementation barriers included cognitive deficits, transportation difficulties and workforce limitations; enablers included structured formats, diverse teaching methods and family involvement. Most studies showed positive behavioural changes, but only one-third reported broader systemic outcomes.
conclusionsLife skills training programmes had been reported to be implemented across diverse settings when appropriately adapted to cultural contexts and resource constraints. Most programmes combine structured learning with real-world practice, accommodate cognitive limitations through diverse teaching methods and engage families in the intervention process. Future research should focus on implementation strategies enhancing skill generalisation, addressing resource limitations in low-income and middle-income countries, and evaluating longer-term outcomes.
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