Project Summary

Cognitive Enhancement Therapy (CET) and Social Skills Training (SST) are evidence-based interventions that improve community functioning of persons with schizophrenia-spectrum illness.

What we know:

  • Schizophrenia and related psychotic disorders are highly disabling.

  • Drug treatments do not improve cognitive and social functioning.

  • Psychosocial rehabilitation improves social functioning.

    • Gains in community functioning may also occur

    • Social Skills Training (SST) is efficacious

  • Cognitive remediation improves cognitive functioning

    • Gains in social and community functioning may also occur

    • Cognitive Enhancement Therapy (CET) is efficacious

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What we need to learn:

  • Is CET more effective than SST in improving community functioning?

  • Do some patients benefit more from one of the two treatments?

Why now?

Effective psychosocial interventions are not widely disseminated in community settings despite social and cognitive deficits in SZ-spectrum illness and the value of treatment. Patients, providers and policymakers do not know the relative benefits of remediating social and cognitive deficits or the extent to which an integrated treatment including cognitive remediation is optimal for those with SZ spectrum illness or for particular subgroups.

 
 
 
 
 

What we will test:

  • CET improves community functioning, neurocognition, social skills more than SST

  • SST is more effective than CET, given better baseline cognitive functioning

  • CET is more effective than SST with younger patients

  • CET and SST are more effective with higher rates of patient engagement

How we will do it:

  • Random assignment of 19 mental health service sites to provide either SST or CET

  • Treatment for 12 months at each site, with groups of 6-8 patients

  • Continual monitoring of treatment delivery, managed by site Principal Investigator

  • Assessment at baseline; during treatment, at 6 months & 12 months; after treatment, at 18 & 24 months