Psychosocial Interventions for Enhancing Social Functioning in Severe Mental Illness: A Systematic Review and Meta-analysis
Author(s): Tanzeela Saeed, Ghazala S. Virk, Muhammad Sohail S. Mirza, Mehwish Aqueel, Fnu Karishma, Maaz Aqueel, Taha Nadeem, Muhammad Abdul Manan Mangral, Binish Essani.
Background: Social functioning is a core domain of recovery in severe mental illness (SMI), yet remains under-addressed by pharmacological treatment. Psychosocial interventions offer promising avenues to improve social outcomes, but evidence remains fragmented. This review aims to evaluate psychosocial interventions in improving social functioning among individuals with SMI and explore how intervention type, comparator condition, and study quality influence outcomes. Methods: This review analyzed seven randomized controlled trials (RCTs), including a total of 1,093 participants. A random-effects model was used to calculate pooled standardized mean differences (SMDs). Subgroup analyses were conducted based on intervention type, control condition, and risk of bias. Results: Psychosocial interventions were associated with a significant improvement in social functioning (pooled SMD = 0.61, 95% CI: 0.12–1.09, p = 0.01). Subgroup analyses showed particularly strong effects for mindfulness-based approaches (SMD = 1.48) and those compared with treatment-as-usual (SMD = 1.14). In contrast, app-based interventions had a negative effect (SMD = –0.81). Differences by control condition were statistically significant (p < 0.00001). When studies with a high risk of bias were excluded in sensitivity analysis, the overall effect size increased (SMD = 0.94, 95% CI: 0.28–1.61). However, heterogeneity was high across studies (I² > 90%). Conclusion: Psychosocial interventions demonstrate a moderate, significant impact on social functioning in SMI, with variability influenced by intervention modality and comparator type. These findings highlight the need for function-focused psychosocial programs as essential components of recovery-oriented care.