Integrated Psychosocial Treatment for Negative Symptoms

Negative symptoms, including restricted affect, diminished emotional range, poverty of speech, decreased motivation and interests, diminished sense of purpose, and diminished social drive, contribute substantially to lost productivity, poor quality of life, social deficits, poor occupational and educational attainment, and generally poor outcomes observed for many individuals with schizophrenia. Although these symptoms may develop from neurobiological factors or as reactions to overstimulation in the acute psychotic phase, they are thought to be maintained by a confluence of biological, cognitive, behavioral, and environmental factors that are not adequately addressed by available treatments. We have developed a multicomponent set of intervention strategies to address persistent negative symptoms called the motivation and engagement (MOVE) program. MOVE builds on research on emotional processing as well as techniques from a variety of behavioral and skill-building approaches to specifically target a broad range of negative symptoms and their functional consequences in an integrated program delivered in the individual's home environment. In this manuscript, we describe an integrated theory for the development and maintenance of negative symptoms, available treatments that target aspects of the syndrome, and evidence supporting the components of MOVE for those with persistent negative symptoms.