Schizophrenia Clinical Trial
Official title:
Cognitive Remediation in Supported Employment at HSC
This project seeks to evaluate the feasibility and effectiveness of combining cognitive remediation and Supported Employment Program (SEP) services to improve work outcomes in people with a serious mental illness who have been unable to benefit from vocational services (i.e., acquire or maintain a job). Cognitive remediation involves treating and improving cognitive impairments, such as memory (e.g., short-term and working memory), attention span, or problem solving skills. It is hypothesized that cognitive remediation will significantly improve peoples' employment outcomes in a supported employment program.
Ample evidence documents that supported employment is an effective strategy for improving
the vocational outcomes of persons with schizophrenia and other severe mental illnesses.
However, a significant amount of clients receiving supported employment services work little
or not at all. With respect to factors that may influence the work outcomes of persons
participating in supported employment programs, cognitive functioning appears to be
potentially important. Cognitive impairment in persons with severe mental illness (SMI) is
strongly correlated with functional adjustment in the community and has been shown to be
correlated with work, both contemporaneously and prospectively. Studies have demonstrated
that clients who did not receive the full benefits of supported employment had more deficits
in executive functioning, memory, and psychomotor speed than those clients who had better
work outcomes.
The current study will use a computerized cognitive training program that will be
administered by a cognitive trainer. The program consists of 24 training modules (each one
takes about one hour to complete). Clients in an SEP who have been unable to maintain a job
that they acquired while in the program can participate in the research. Clients who have
agreed to participate in the research project will be randomly assigned to either receive
the computerized training and supported employment services (CT-SES) or supported employment
services (SES) without the training (i.e., treatment-as-usual-condition). Both research
groups will receive the same baseline, three-month, and 12-month follow up interviews that
will consists of a brief clinical and neuropsychological evaluation, an assessment of
problems associated with finding or maintaining employment, and employment outcomes while
enrolled in the study. In addition, both groups will receive a telephonic interview at 18
and 24 months to assess their employment outcomes (clinical and neurological information
will not be collected at 18 or 24 months).
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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