One example of such an integrated neurocognitive therapy program is Integrated Psychological Therapy (IPT ) (Roder et al. 1988, 2008, 2010). It combines neurocognitive and social-cognitive remediation therapy with the therapy of social competencies and interpersonal problem-solving abilities. IPT is divided into five modules of increasing complexity which build upon each other (Fig. 1.2): In the first module, “Cognitive Differentiation”, various neurocognitive functions should be improved (e.g. attention, verbal memory, cognitive flexibility, concept-formation). The second module, “Social Perception”, addresses operations of social-cognitive information processing such as social and emotional perception. The link between the first two cognitively oriented modules and the last two, more behavior-oriented modules is established by the third module, “Verbal Communication”. It aims at improving verbal fluency and executive functions, which are necessary for interpersonal relationships. In the last two modules, “Social Skills” and “Interpersonal Problem Solving”, role play and group problem-solving exercises promote the acquisition of social skills. The group is led by one therapist and one co-therapist and comprises five to eight participants. It is best carried out twice a week for 60 min over a period of at least 3 months. Additional homework assignments, in vivo exercises, and individual therapy supplement these group sessions.

IPT has been evaluated in 36 independently published studies in 12 countries in Europe, America and Asia (Roder et al. 2006, 2011). The manual is now obtainable in 13 languages. The summarization of these individual study results in meta-analytic techniques speaks for the effectiveness of IPT in comparison to placebo-attention or empty control groups in the area of neurocognition and social cognition, negative symptomatology, and the level of psychosocial functioning. These effects also remained unchanged after a follow-up period (Roder et al. 2006, 2010). IPT thus represents one of the first systematic, manual-based cognitive approaches to group therapy for people suffering from schizophrenia. IPT was initially conceived over 30 years ago (Brenner et al. 1980). IPT’s conception thus anticipated the growing importance of social cognition and an integrative approach to treatment. On the basis of the IPT approach, two further developments arose against the backdrop of the new state of empirical and theoretical knowledge described above (Fig. 1.3).

As an initial step, our team expanded the two IPT modules “social skills” and “interpersonal problem solving” by developing specific group therapy programs for social competencies in the residential, vocational, and recreational domains (abbreviated WAF, from the German “Wohnen, Arbeit, Freizeit”) (Roder et al. 2008). WAF has the aim of sensitizing participants’ perceptions of their own needs in these areas of everyday life. Building upon this, it strives to support the formation of goals for specific residential, vocational, or recreational situations. In order to help implement patients’ decisions, the group rehearses necessary social competencies and activates both potential difficulties and existing resources. WAF too has been evaluated in effectiveness studies. These showed, in conformity with the recovery perspective, that the therapy’s concern with everyday life contributed to an increase in patient motivation. This is a decisive prerequisite for improving social competencies and reducing negative symptoms (Mueller and Roder 2005; Roder et al. 2006).

Integrated Neurocognitive Therapy (INT) represents a further step in this development. IPT also had an influence on INT’s treatment approach and therapeutic methods. INT encompasses all 11 of the neurocognitive and social-cognitive MATRICS areas and thus expands on the first two IPT modules. The combined treatment of neurocognitive and social-cognitive functions are also based on the results of IPT research: Implementation of all five IPT modules resulted, with the same therapy duration, in greater and longer-lasting effects compared with individual neurocognitive modules (Roder et al. 2006, 2010; Mueller et al. 2007). IPT focuses initially on basal neurocognitive functions before moving increasingly to social-cognitive processes and finally to complex interpersonal skills. This didactic structure makes it possible for the participants to become accustomed to the group context quickly. They can also have a sense of achievement already at the beginning of the therapy process thanks to clearly structured tasks which are not emotionally stressful. Improvement of basal neurocognitive functions appears to be a necessary requirement for the rehabilitation of social-cognitive functions and social skills, since they are seen to be limiting factors for therapy success. Accordingly, the therapeutic content of INT is also organized into sequential modules. In the process of therapy, the degree of emotional activation and the complexity of the exercises grow with time while being increasingly less structured by the therapists. Consistent with IPT, INT was also conceived as a cognitive-behavioral approach to group therapy. The reason for this is that, in this setting, group processes arise that are relevant to everyday life but nonetheless provide safe conditions, thus easing the learning of social skills (Mueller et al. 2011).

Given the theoretical background outlined here and the current state of empirical knowledge, an integrative and well-coordinated treatment and rehabilitation of patients with schizophrenia from the standpoints of both functional and subjective recovery remains an important future goal. Studies have showed that medicinal treatment with typical and atypical neuroleptics yield few positive effects on the level of cognitive functioning, with moderate effects on negative symptoms and the level of psychosocial functioning (Bowie and Harvey 2005; Harvey et al. 2007; Keefe et al. 2007, 2011). Accordingly, the importance of multidimensional, integrative approaches to psychological treatment, focusing on the cognitive and social impairments brought on by the illness, will increase considerably in the years ahead.