ABSTRACT
BACKGROUND: People with psychosis have a range of neuropsychological impairments that impact their functional abilities and rehabilitation outcomes. We designed a Computer-Assisted Cognitive Remediation (CACR) program to help young people with psychosis to restore their cognitive function. The program combines the drill-and-practice approach and the strategic approach to remediation, with sixteen sessions of computerized cognitive training, two sessions of psychoeducation, and four session of coaching on applying cognitive skills to daily life. METHOD: This was a randomized, single-blind, controlled study in which the outcomes of the CACR program were compared with outcomes of a treatment-as-usual (TAU) control group. Pre-intervention and post-intervention measures were compared. RESULTS: When compared with the control group, the intervention group had significant increases in their MCCB neurocognitive composite scores, and specifically in the areas of verbal learning and speed of processing at posttest. They also had significant increases in their secondary outcome measures of mental well-being and perceived occupational competence. There were no significant differences in functional status between the two groups at post-test. CONCLUSIONS: The CACR program was effective in improving overall cognitive function and in the specific domains of verbal learning, speed of processing, and effect sizes were small. Participants also experienced positive changes in mental well-being and perceived competence.
ABSTRACT
OBJECTIVE: This study examined the vocational outcomes of young persons with early psychosis after their participation in an occupational therapy program, and identified clinical or process variables that are linked to the vocational outcomes. PARTICIPANTS: A total of 147 clients, aged between 15 and 25, with early psychosis or schizophrenia participated in this study. METHODS: A retrospective review of case management plans and outcomes was conducted. A survey form was designed to record demographic and clinical variables, and a follow-up telephone interview was conducted to monitor the vocational status of clients during the first three months after discharge. RESULTS: Although none of the clients had been engaged in work prior to participation in the programme, 53.7% could maintain a productive role in work (27.2%) or training/education (16.3%) in the three-month follow-up. Better mental condition and insight, stronger motivation for joining treatment, better social support, longer work history, and a shorter period of idleness before joining the programme, were significantly related to more favourable vocational outcomes. Older clients and those with more years of education were more likely to maintain a worker role. Parents were much more conservative about the future work plan than the clients themselves. CONCLUSIONS: Symptom management, work habit training, enrichment of the work experience, building social support and cultivation of insight into illness were important strategies related to the successful adoption of a productive role.
