Dr. Penn and Colleagues Reply

To The Editor:

We thank Dr. Kanas for his comments on our article and appreciate the opportunity to respond to his letter. However, we stand by our statement that, to our knowledge, no randomized, controlled trials of group intervention for first-episode psychosis have been conducted. Dr. Kanas is correct in pointing out that there is a large research literature on the effectiveness of group intervention for schizophrenia and that it is likely that many of these published studies included some first-episode patients. Similarly, it is likely that many of the controlled studies of other psychosocial treatments for the broader population of subjects with schizophrenia included some first-episode patients, such as studies of family psychoeducation, cognitive behavior therapy for psychosis, supported employment, and social skills training. However, because of the unique treatment needs of first-episode patients, our review focused on studies evaluating the effectiveness of psychosocial treatment for this specific subpopulation. When we consider the evidence supporting the effectiveness of group interventions for schizophrenia, as discussed by Dr. Kanas, there is clearly a need for research evaluating their impact on persons with a first episode of psychosis. We hope that our article, as well as the letter by Dr. Kanas, will contribute to future research in this area.