Poster #T50 IS COGNITIVE REMEDIATION THERAPY AN EFFECTIVE INTERVENTION IN ENHANCING VOCATIONAL OUTCOMES FOR PEOPLE WITH SEVERE MENTAL ILLNESS?

Cognitive remediation refers to nonpharmacological methods of improving cognitive function in people with severe mental disorders. Cognitive remediation therapy (CRT) can be delivered via computerised programs, of varying length and complexity, or can be undertaken one-on-one by a trained clinician. There has been a considerable interest in cognitive remediation, driven by recognition that cognitive deficits are a major determinant of outcome in people with severe, chronic mental illnesses. CRT has been shown to be effective, especially if combined with vocational rehabilitation.

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How Effective is Cognitive Remediation in Enhancing Vocational Outcomes for Job Seekers with Severe Mental Illness in Australia?

Australian Psychologist ◽

10.1111/ap.12256 ◽

2016 ◽

Vol 53 (2) ◽

pp. 144-150 ◽

Cited By ~ 1

Author(s):

Natalia A. Contreras ◽

David J. Castle ◽

Caroline Crosse ◽

Dea Morgain ◽

Ellie Fossey ◽

...

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Cognitive Remediation ◽

Job Seekers ◽

Vocational Outcomes

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The effect of rehabilitation combined with cognitive remediation on functioning in persons with severe mental illness: systematic review and meta-analysis

Psychological Medicine ◽

10.1017/s003329171800418x ◽

2019 ◽

Vol 49 (09) ◽

pp. 1414-1425 ◽

Cited By ~ 5

Author(s):

Daniëlle van Duin ◽

Lars de Winter ◽

Matthijs Oud ◽

Hans Kroon ◽

Wim Veling ◽

...

Keyword(s):

Mental Illness ◽

Severe Mental Illness ◽

Meta Analysis ◽

Psychiatric Rehabilitation ◽

Real Life ◽

Cognitive Remediation ◽

Beneficial Effects ◽

Moderator Effects ◽

Vocational Outcomes ◽

Meta Regression Analysis

AbstractBackgroundPsychiatric rehabilitation (PR) can improve functioning in people with severe mental illness (SMI), but outcomes are still suboptimal. Cognitive impairments have severe implications for functioning and might reduce the effects of PR. It has been demonstrated that performance in cognitive tests can be improved by cognitive remediation (CR). However, there is no consistent evidence that CR as a stand-alone intervention leads to improvements in real-life functioning. The present study investigated whether a combination of PR and CR enhances the effect of a stand-alone PR or CR intervention on separate domains of functioning.MethodA meta-analysis of randomized controlled trials of PR combined with CR in people with SMI was conducted, reporting on functioning outcomes. A multivariate meta-regression analysis was carried out to evaluate moderator effects.ResultsThe meta-analysis included 23 studies with 1819 patients. Enhancing PR with CR had significant beneficial effects on vocational outcomes (e.g. employment rate: SMD = 0.41), and social skills (SMD = 0.24). No significant effects were found on relationships and outcomes of community functioning. Effects on vocational outcomes were moderated by years of education, intensity of the intervention, type of CR approach and integration of treatment goals for PR and CR. Type of PR was no significant moderator.ConclusionsAugmenting PR by adding cognitive training can improve vocational and social functioning in patients with SMI more than a stand-alone PR intervention. First indications exist that a synergetic mechanism also works the other way around, with beneficial effects of the combined intervention compared with a stand-alone CR intervention.

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Predictors of employment for people with severe mental illness: results of an international six-centre randomised controlled trial

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.041475 ◽

2008 ◽

Vol 192 (3) ◽

pp. 224-231 ◽

Cited By ~ 128

Author(s):

Jocelyn Catty ◽

Pascale Lissouba ◽

Sarah White ◽

Thomas Becker ◽

Robert E. Drake ◽

...

Keyword(s):

Mental Illness ◽

Randomised Controlled Trial ◽

Severe Mental Illness ◽

Controlled Trial ◽

Patient Characteristics ◽

Employment Outcomes ◽

Social Needs ◽

Vocational Outcomes ◽

Randomised Controlled ◽

Ips Model

BackgroundAn international six-centre randomised controlled trial comparing individual placement and support (IPS) with usual vocational rehabilitation for people with serious mental illness found IPS to be more effective for all vocational outcomes.AimsTo determine which patients with severe mental illness do well in vocational services and which process and service factors are associated with better outcomes.MethodPatient characteristics and early process variables were tested as predictors of employment outcomes. Service characteristics were explored as predictors of the effectiveness of IPS.ResultsPatients with previous work history, fewer met social needs and better relationships with their vocational workers were more likely to obtain employment and work for longer. Remission and swifter service uptake were associated with working more. Having an IPS service closer to the original IPS model was the only service characteristic associated with greater effectiveness.ConclusionsThe IPS service was found to be more effective for all vocational outcomes. In addition, maintaining high IPS fidelity and targeting relational skills would be a valuable focus for all vocational interventions, leading to improved employment outcomes. Motivation to find work may be decreased by satisfaction with current life circumstances.

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