International Journal of Psychiatry in Clinical Practice, 2010; 14: 137–144
ISSN 1365-1501 print/ISSN 1471-1788 online © 2010 Informa UK Ltd. (Informa Healthcare, Taylor & Francis AS)
DOI: 10.3109/13651500903569613
Correspondence: Hector W.H. Tsang, PhD, Associate Professor, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom,
Hong Kong. Tel: +852 2766 6750. Fax: +852 2330 8656. E-mail: rshtsang@inet.polyu.edu.hk
(Received 22 June 2009; accepted 17 December 2009)
ORIGINAL ARTICLE
Outcomes of the Chinese Basic Conversation Skill Module (CBCSM)
for people with schizophrenia having mild to moderate symptoms and
dysfunction in Hong Kong
DAVIS C. C. LAK
1
, HECTOR W. H. TSANG
1
, ALEX KOPELOWICZ
2
& ROBERT P. LIBERMAN
2
1
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong, Kong, and
2
University of
California Los Angeles, Los Angeles, CA, USA
Abstract
This study tested the effectiveness of a culturally adapted Chinese Basic Conversation Skill Module (CBCSM) for Hong
Kong Chinese with schizophrenia. A total of 106 participants with schizophrenia who had mild to moderate levels of
symptoms and dysfunction were recruited between January 2004 and September 2005. After random allocation, 35 par-
ticipants were assigned to the CBCSM group with skill generalization training (SGT), 35 participants were assigned to the
CBCSM group without SGT, and 36 participants were assigned to the placebo group. All participants were assessed by a
blind rater at baseline, 5 weeks after commencement of skills training, and 3 and 6 months after completion of skills train-
ing on conversation skill mastery, subjective personal well being, and self esteem. After 15 sessions of intervention, the
CBCSM group with SGT and the CBCSM group outperformed the placebo group in social skills. At the 6-month follow-
up, social skill of CBCSM group with SGT was better than the CBCSM group and the placebo group. CBCSM with SGT
was found to be effective in improving conversation skill of people with schizophrenia in Hong Kong. This combined
strategy was also shown to be better than mere application of CBCSM in helping conversation skill mastery.
Key Words: Schizophrenia, social skills training, generalization strategy
Introduction
Effective communication is a basic element for per-
sonal coping and reflection of social competence [1–3].
Individuals with schizophrenia however suffer from
deficits in communication skills that prevent their
participation in community activities [4]. Social skills
training (SST) is an evidence-based practice that helps
people with schizophrenia acquire communication skills
necessary for successful community living [5–10]. Des-
pite its positive effects in laboratory settings, its long-
term effects and generalization to natural environment
is less conclusive [11]. Studies suggest that follow-up
support is essential to ensuring skill maintenance and
skill generalization [12,13].
As Chinese individuals with schizophrenia have
also demonstrated deficits in social skills [14], we
translated and culturally adapted the UCLA Basic
Conversation Skill module [15] into the CBCSM for
use in Hong Kong [16]. We conducted a RCT using
the CBCSM with a view to: (1) assessing the effects
of the CBCSM on social competence of Chinese
people with schizophrenia who had mild to moderate
levels of symptoms and dysfunction and (2) investi-
gating the effectiveness of a generalization strategy
designed to extend and maintain the gains made in
the classroom training.
Method
Participants
Recruitment of participants took place at Kowloon
Hospital, Halfway Houses, and Long Stay Care Homes
in Hong Kong. The selection criteria included an ICD-
10 diagnosis of schizophrenia; completion of primary
education; aged between 18 and 50 of either sex; being
free from florid positive symptom as indicated by
BPRS with a score less than 72; and a Global Assess-
ment of Functioning score over 50. Subjects with any
major physical illness, organic brain disease, mental
retardation, or active substance abuse were excluded.
Int J Psych Clin Pract Downloaded from informahealthcare.com by Hospital Authority Head Office HAHO on 06/26/13
For personal use only.