patients. Second, the magnitude of deficits in social and living skills has been well documented in chronic psychiatric patients. For example, in one study major functional deficits in social and personal areas were found in over 50 percent of a sample of chronic psychiatric patients (Sylph, Ross, and Kedward 1978). Two studies of schizophrenic patients found that both discharge and remission rates were significantly higher among patients who had higher levels of living and social skills (Linn, Klett, and Caffey 1980; Farkas, Rogers, and Thurer 1986). In another large-scale study comparing depressed patients and normals, social introversion and interpersonal dependency were the most significant premorbid personal characteristics associated with the patient sample (Hirschfeld et al. 1983). Moreover, the recent scientific literature has seen publication of well-controlled and efficacious training programs to enhance social, vocational, and living skills (Monti et al. 1979; Nelson and Cone 1979; Monti, Corriveau, and Curran 1982; Falloon, Boyd, and McGill 1984; Jacobs et al. 1984; Kelly and Lampariski 1985). The learning of social and living skills is often affected—for better or worse—by the concurrent administration of appropriate types and doses of psychotropic drugs; therefore, it is important for rehabilitation practitioners using skills-training methods to work in close liaison with medicalpsychiatric practitioners who prescribe psychotropic drugs. Judicious administration of psychotropic drugs reduces cognitive and symptomatic impairments, enabling patients to attend to learning stimuli and to engage actively in skillstraining procedures (Liberman, Falloon and Wallace 1984). In 1974, Anthony and Margules published a review which concluded that "persons with a psychiatric disability can in fact learn useful skills" (p. 102). Specifically, the studies reviewed at that time, and again 10 years later (Anthony, Cohen, and Cohen 1984), showed that psychiatrically disabled persons could learn a variety of self-care, social-interpersonal, and intellectual skills. For example, training programs have had an impact on the psychiatrically disabled persons skills in a variety of areas, including personal Downloaded from https://academic.oup.com/schizophreniabulletin/article/12/4/542/1874999 by guest on 23 November 2021 VOL. 12, NO. 4, 1986 551 hygiene, cooking, use of public transportation, use of recreational facilities, physical fitness, interpersonal skills, self-control skills, job-interviewing skills, family relationship skills, money management, and jobseeking and work-adjustment skills (Anthony 1979; Falloon, Doane, and Pederson 1985; Wallace and Liberman 1985). In many of these studies psychiatrically disabled persons who were long-term inpatients with a lengthy history of symptomatic behavior were successfully trained. For example, longitudinal, followthrough study of over 200 chronic psychotic patients who were involved in an intensive rehabilitation program as part of their discharge from Vermont State Hospital in the late 1950s found that approximately two-thirds were functioning in a near-normal fashion in social and vocational roles 20 years later in the community (Harding and Brooks 1984). It has now become an accepted fact that psychiatrically disabled persons can learn skills, and that chronicity and symptomatology may qualify but do not prevent skill learning. The results of these studies are thus seen as supportive of a psychiatric rehabilitation approach, with its emphasis on assessing and increasing psychiatrically disabled persons' skills. Social and vocational skills training uses procedures based on principles of human learning to train specific interpersonal skills and to promote the generalization and maintenance of these skills. The training procedures have been empirically tested and "packaged" for ready access by practitioners. While many psychosocial programs bill themselves as offering social-skills training, it is important to distinguish between nonspecific group activities that engage patients in "socialization," and methods that deliberately and systematically use behavioral learning techniques in a structured approach to skills building (Farkas, Cohen, and Nemec 1986). While