Social Skills Training — MRCPsych Paper B MCQ

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EasyRehabilitationSocial Skills TrainingMRCPsych Paper B

A patient with complex schizophrenia is receiving community rehabilitation. Their psychotic symptoms are stable, but they have marked difficulty interacting with others and independently shopping, budgeting and cooking. Which intervention most directly addresses these functional impairments?

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Correct answer: A — Structured group activities and daily living skills practice

The correct answer is A. NICE recommends structured social, leisure or occupational group activities to improve interpersonal skills in people receiving rehabilitation for complex psychosis. It also recommends individualised, practical activities to develop daily living skills such as shopping, budgeting and cooking, ideally practised in real-life settings. CBTp targets psychotic symptoms and associated distress rather than directly teaching these functional skills. Family intervention primarily improves family communication and reduces relapse risk. Clozapine augmentation is reserved for inadequately controlled treatment-resistant symptoms, which are stable here. Arts therapy may help negative symptoms but is not the most direct intervention for the specified interpersonal and practical deficits. NICE CG178 advises against routinely offering social skills training as a distinct psychological intervention, so the current rehabilitation terminology is preferable.

Reference: NICE, Rehabilitation for adults with complex psychosis (NG181), sections 1.8.1–1.8.4, 2020. https://www.nice.org.uk/guidance/NG181/chapter/recommendations