Quality of Research
Documents Reviewed
The documents below were reviewed for Quality of Research. The research point of
contact can provide information regarding the studies reviewed and the availability
of additional materials, including those from more recent studies that may have been conducted.
Study 1Patterson, T. L., McKibbin, C., Taylor, M., Goldman, S., Davila-Fraga, W., Bucardo, J., et al. (2003). Functional Adaptation Skills Training (FAST): A pilot psychosocial intervention study in middle-aged and older patients with chronic psychotic disorders. American Journal of Geriatric Psychiatry, 11(1), 17-23.  Study 2Patterson, T. L., Mausbach, B. T., McKibbin, C., Goldman, S., Bucardo, J., & Jeste, D. V. (2006). Functional Adaptation Skills Training (FAST): A randomized trial of a psychosocial intervention for middle-aged and older patients with chronic psychotic disorders. Schizophrenia Research, 86, 291-299.
Supplementary Materials Bowie, C. R., Reichenberg, A., Patterson, T. L., Heaton, R. K., & Harvey, P. D. (2006). Determinants of real-world functioning performance in schizophrenia subjects: Correlations with cognition, functional capacity, and symptoms. American Journal of Psychiatry, 163(3), 418-425.
Mausbach, B. T., Bowie, C. R., Harvey, P. D., Twamley, E. W., Goldman, S. R., Jeste, D. V., et al. (2007). Usefulness of the UCSD Performance-Based Skills Assessment (UPSA) for predicting residential independence in patients with chronic schizophrenia. Journal of Psychiatric Research, Feb 13 [Epub ahead of print].
Patterson, T. L., Bucardo, J., McKibbin, C. L., Mausbach, B. T., Moore, D., Barrio, C., et al. (2005). Development and pilot testing of a new psychosocial intervention for older Latinos with chronic psychosis. Schizophrenia Bulletin, 31(4), 922-930.
Patterson, T. L., Goldman, S., McKibbin, C. L., Hughs, T., & Jeste, D. V. (2001). UCSD Performance-Based Skills Assessment: Development of a new measure of everyday functioning for severely mentally ill adults. Schizophrenia Bulletin, 27(2), 235-245.
Patterson, T. L., Lacro, J., McKibbin, C. L., Moscona, S., Hughs, T., & Jeste, D. V. (2002). Medication management ability assessment: Results from a performance-based measure in older outpatients with schizophrenia. Journal of Clinical Psychopharmacology, 22(1), 11-19.
Patterson, T. L., Moscona, S., McKibbin, C. L., Davidson, K., & Jeste, D. V. (2001). Social skills performance assessment among older patients with schizophrenia. Schizophrenia Research, 48(2-3), 351-360.
Outcomes
| Outcome 1: Everyday living skills |
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Description of Measures
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The University of California, San Diego (UCSD) Performance-Based Skills Assessment (UPSA) was used to assess everyday living skills. UPSA requires participants to role-play a variety of complex situations, including management of finances, social and communication skills, transportation, and household chores. Participants were given a score by the clinician in each functional area, and all scores were summed. Higher total scores indicated better functioning and improved everyday living skills.
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Key Findings
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FAST participants showed improved performance on everyday living skills, compared with patients who only received their usual medications. Everyday functioning remained significantly better through a 3-month maintenance follow-up period (p < .0016).
In another evaluation, FAST participants had significantly improved everyday living skills at 6-month follow-up, compared with patients who received medications as usual and participated in sessions addressing personal problems (p = .046).
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Studies Measuring Outcome
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Study 1, Study 2
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Study Designs
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Experimental
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Quality of Research Rating
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3.2
(0.0-4.0 scale)
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| Outcome 2: Social and communication skills |
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Description of Measures
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Social and communication skills were assessed using the clinician-rated Social Skills Performance Assessment (SSPA). Participants engaged in two 3-minute role-plays simulating interactions with a new neighbor and a landlord, respectively. For each role-play, participants were rated from 1 (low) to 5 (high) on a number of domains including interest, fluency, clarity, affect, and social appropriateness. All scores were then summed. A higher total score indicated improved social and communication skills.
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Key Findings
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FAST participants demonstrated significant improvement in social and communication skills at 6-month follow-up, compared with patients who received medications as usual and participated in sessions addressing personal problems (p = .003).
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Studies Measuring Outcome
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Study 1
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Study Designs
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Experimental
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Quality of Research Rating
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3.4
(0.0-4.0 scale)
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Study Populations
The following populations were identified in the studies reviewed for Quality of
Research.
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Study
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Age
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Gender
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Race/Ethnicity
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Study 1
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26-55 (Adult)
55+ (Older adult)
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68.8% Male
31.3% Female
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78.1% White
12.5% Black or African American
3.1% Asian
3.1% Hispanic or Latino
3.1% Race/ethnicity unspecified
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Study 2
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26-55 (Adult)
55+ (Older adult)
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65% Male
35% Female
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53.3% White
25% Hispanic or Latino
13.8% Black or African American
3.8% Asian
3.3% American Indian or Alaska Native
0.8% Race/ethnicity unspecified
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Quality of Research Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the Quality of Research for an intervention's
reported results using six criteria:
For more information about these criteria and the meaning of the ratings, see Quality of Research.
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Outcome
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Reliability
of Measures
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Validity
of Measures
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Fidelity
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Missing
Data/Attrition
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Confounding
Variables
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Data
Analysis
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Overall
Rating
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1: Everyday living skills
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3.5
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4.0
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3.5
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3.5
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2.0
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2.8
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3.2
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2: Social and communication skills
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3.5
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4.0
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3.5
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4.0
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2.5
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3.0
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3.4
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Study Strengths The intervention was well conceived. The outcome measures appear to be well established, and their psychometric properties were well addressed in the supporting documents. The studies accounted for most confounding factors.
Study Weaknesses The studies did not adequately account for initial group differences and did not have a sufficient number of older adults (persons over 60 years old) to clearly support findings for that age group.
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Readiness for Dissemination
Materials Reviewed
The materials below were reviewed for Readiness for Dissemination. The implementation
point of contact can provide information regarding implementation of the intervention
and the availability of additional, updated, or new materials.
FAST prescription labels
Mausbach, B. T., Bowie, C. R., Harvey, P. D., Twamley, E. W., Goldman, S. R., Jeste, D. V., et al. (2007). Usefulness of the UCSD Performance-Based Skills Assessment (UPSA) for predicting residential independence in patients with chronic schizophrenia. Journal of Psychiatric Research, Feb 13 [Epub ahead of print].
Modules 1-6 from Functional Adaptation Skills Training (FAST) Intervention Manual
Patterson, T., & Goldman, S. (2001). Social Skills Performance Assessment (SSPA) Manual.
Patterson, T., & Goldman, S. (2001). The UCSD Performance-Based Skills Assessment (UPSA) Manual.
Patterson, T., & Goldman, S. (2003). Medication Management Ability Assessment (MMAA) Manual.
Readiness for Dissemination Ratings by Criteria (0.0-4.0 scale)
External reviewers independently evaluate the intervention's Readiness for Dissemination
using three criteria:
- Availability of implementation materials
- Availability of training and support resources
- Availability of quality assurance procedures
For more information about these criteria and the meaning of the ratings, see Readiness for Dissemination.
Implementation
Materials
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Training and Support
Resources
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Quality Assurance
Procedures
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Overall
Rating
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2.5
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0.5
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2.3
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1.8
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Dissemination Strengths Intervention manual modules are clearly structured and detailed with session-by-session agendas and instructions for group leaders. Outcome measures assessing change in functional capabilities are provided to support quality assurance.
Dissemination Weaknesses No program overview or discussion of intended outcomes is provided. Program materials do not speak to the variability of skills and abilities among adults with schizophrenia. No information is provided on required experience and qualifications of group leaders. Though some materials and embedded information may support training, no clear training or support resources are provided to implementers. The relationship between the assessment measures and the intervention modules is not clear. No measures or indicators for fidelity are provided to support quality assurance.
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Costs
The cost information below was provided by the developer. Although this cost information
may have been updated by the developer since the time of review, it may not reflect
the current costs or availability of items (including newly developed or discontinued
items). The implementation point of contact can provide current information and
discuss implementation requirements.
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Item Description
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Cost
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Required by Developer
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Treatment manual
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$300 for a set of 12
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Yes
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Props
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$370
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Yes
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2-day, on- or off-site training workshop
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$1,600 per workshop (plus travel expenses if applicable)
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Yes
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Phone consultation with training staff
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$100 per hour
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Yes
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Additional Information The cost for training and delivering the intervention to a group of 10 patients is estimated at $4,500, plus fees for technical assistance (if applicable). This estimate includes the cost of treatment materials (treatment manuals and props) as well as fees and travel costs for two trainers conducting a 2-day, on-site training workshop. The total cost per patient is estimated at $450.
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Replications
Selected citations are presented below. An asterisk indicates that the document
was reviewed for Quality of Research.
Patterson, T. L., Bucardo, J., McKibbin, C. L., Mausbach, B. T., Moore, D., Barrio, C., et al. (2005). Development and pilot testing of a new psychosocial intervention for older Latinos with chronic psychosis. Schizophrenia Bulletin, 31(4), 922-930.
* Patterson, T. L., Mausbach, B. T., McKibbin, C., Goldman, S., Bucardo, J., & Jeste, D. V. (2006). Functional Adaptation Skills Training (FAST): A randomized trial of a psychosocial intervention for middle-aged and older patients with chronic psychotic disorders. Schizophrenia Research, 86, 291-299.
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