For people with schizophrenia, the first symptoms typically appear when they are in their mid-teens through around age 30, and treatment of the chronic, recurring disease is most effective when started during that initial or acute phase.
But many people are diagnosed and begin treatment later, or they relapse after stopping the powerful antipsychotics due to side effects and the chaos of homelessness.
Effective treatment at that point is far more challenging, as patients spiral downward and may resist help. Medical and mental comorbidities are common with schizophrenia, further complicating treatment.
Could adding group therapy focused on health education and cognition, with the group benefit of social connections, make a difference for psychiatric patients who were diagnosed years earlier?
A small, short-term study published Aug. 1, 2025, in the journal Medicine examined that question. It found significant improvement in treatment compliance, symptoms of depression and cognitive function after eight weeks of specifically focused group therapy. Treatment plans were individualized.
The two researchers who conductded the study — corresponding author Zhiyong Nie, B.Med., who has an appointment in the psychiatry department at The Second Psychiatric Hospital of Wuhan in Wuhan, China, and Yurong Lu, B.Nurs., at the same institution—randomly divided 92 patients diagnosed with schizophrenia who were admitted to their hospital between January 2019 and December 2022 into two groups of 46 patients each.
Both the intervention and control groups were more or less evenly divided between males and females, had an average age of approximately 46, and were diagnosed, on average, approximately six years earlier. Participants in both groups received the same daily medications: the third-generation antipsychotic aripiprazole and the “atypical antipsychotic” clozapine. Aripiprazole is available as a generic and also sold under Abilify and other brand names. Clozapine is also available as a generic and also sold under Clozaril and other brand names.
In a group but with individual attention
What the authors refer to as a “psychological nursing intervention” consisted primarily of twice-weekly group therapy sessions with four to six individuals led by psychotherapists. The researchers emphasize that the group sessions included a great deal of individual attention, guidance and discussion that sounds at times almost like individual therapy conducted in a group setting.
“While group therapy aimed to facilitate mutual support among patients through collective discussions, individualized treatment was provided separately, focusing on the specific needs of each patient,” according to the study.
The group therapy included several interventions:
- Health education systematically introduced schizophrenia’s causes, symptoms and treatment methods — with materials tailored to patients’ gender, age and educational background — to help participants better understand their condition. Individualized feedback was provided within the group sessions.
- A cognitive intervention aimed at improving patients’ cognitive function included “structured cognitive tasks designed to engage all participants while allowing for individualized adjustments based on each patient’s specific needs,” according to the study. Self-introductions, including personal information, medical history, life difficulties, and treatment goals, were intended to help reduce social distance among patients and improve clinical compliance.
- For managing negative emotions, attention-shifting techniques were used to help patients redirect their focus more positively, “fostering a more adaptive coping mechanism.”
- Family members played an integral role in the therapy and were encouraged to attend the group sessions. Therapists also led separate family sessions to discuss specific strategies for dealing with patients’ emotional needs.
After eight weeks, the intervention group improved significantly compared with controls on a psychiatric rating scale that was used to assess depressive symptoms and also on various additional subscales such as anxiety, thought disturbance, hostility/suspicion, and others.
Both groups showed substantial improvement in cognitive function, but the intervention group improved significantly more. Treatment compliance in the intervention group was 93% vs. 76% in the control group.
A measure of treatment effectiveness showed the total effective rate in the intervention group was 96%, significantly higher than the control group’s 70%.
An earlier study that investigated a similar combination of psychotherapy and medication in schizophrenia patients yielded similar findings, but the authors of the new research noted an important difference in the study populations.
The 2017 study focused on patients in the acute phase of schizophrenia. The new study examined patients in the later rehabilitation phase, which presents different treatment challenges, such as maintaining compliance and cognitive function.
“Our results suggest that psychotherapy combined with drug therapy is especially beneficial for patients in the rehabilitation phase, helping them manage personal, family, and social relationships, which in turn enhances recovery outcomes,” the researchers wrote.
“In short,” they concluded, “compared with conventional nursing interventions, psychological nursing interventions given to patients with schizophrenia have a more significant therapeutic effect, can improve patients’ depression symptoms, improve patients’ treatment compliance, [and] ensure the quality of life of patients.