Cognitive–behavioural interventions in schizophrenia

Hodgins & Müller-Isberner (2004) in their clinical implications assert that schizophrenia patients with antisocial behaviour ‘require cognitive–behavioural interventions aimed at changing antisocial behaviours...’, yet the paper itself can only quote evidence of effectiveness of these techniques in offenders who are not mentally ill (McGuire, 1995). It therefore seems unclear why they then suggest that these techniques will be effective in reducing antisocial behaviours in people with schizophrenia and should be regarded as ‘required’. Unfounded assumptions like these may be quoted by others referencing this paper and lead people to assume, mistakenly, an evidence base for this assertion. Providing cognitive–behavioural therapy to this client group may therefore provide no benefit but divert resources that may have benefited others. While I agree that reducing antisocial behaviour in this client group is desirable, we should not hasten to assume, in the absence of evidence, that cognitive–behavioural therapy will provide a panacea.