Treatment Principles

2017 ◽  
pp. 9-30
Author(s):  
Alice Medalia ◽  
Tiffany Herlands ◽  
Alice Saperstein ◽  
Nadine Revheim
Keyword(s):  
Psychosocial Functioning ◽  
Cognitive Skills ◽  
Psychiatric Patients ◽  
Cognitive Remediation ◽  
Evidence Base ◽  
Learning Needs ◽  
Program Structure ◽  
Educational Approach ◽  
Individualized Learning ◽  
Treatment Principles

Chapter 2 provides the theoretical foundation and goals that inform the Neuropsychological Educational Approach to Remediation (NEAR). NEAR is a method of cognitive remediation that was developed for psychiatric patients. This group-based treatment provides highly individualized learning by allowing each person in the group to work at his own pace on tasks carefully chosen to be engaging and to address cognitive and learning needs. The NEAR program structure is described along with an explanation of the treatment principles and what the sessions look like. The evidence base for using NEAR is reviewed. Research indicates that participation in NEAR affects the client’s cognitive skills and psychosocial functioning.

Cognitive Remediation for Psychological Disorders

2017 ◽  
Author(s):  
Alice Medalia ◽  
Tiffany Herlands ◽  
Alice Saperstein ◽  
Nadine Revheim
Keyword(s):  
Cognitive Functioning ◽  
Cognitive Skills ◽  
Behavioral Treatment ◽  
Learning Experience ◽  
Cognitive Remediation ◽  
Mental Illnesses ◽  
Independent Learning ◽  
Evidence Based ◽  
Everyday Functioning ◽  
Educational Approach

Individuals with serious and persistent mental illnesses, including schizophrenia and affective disorders, often experience cognitive deficits that make it difficult to perform everyday tasks. For example, they may have difficulty with attention, memory, processing speed, and problem solving, and this may interfere with functioning at work, school, and in social situations. Cognitive remediation is an evidence-based behavioral treatment for people who are experiencing cognitive impairments that interfere with role functioning. This edition contains all the information needed to set up a cognitive remediation program so clients can strengthen the cognitive skills needed for everyday functioning. The program described is called Neuropsychological and Educational Approach to Remediation (NEAR), which is an evidence-based approach to cognitive remediation that uses carefully crafted instructional techniques that reflect an understanding of how people learn best. The goals of NEAR are to provide a positive learning experience, to promote independent learning, and to promote optimal cognitive functioning in daily life. This second edition of the popular 2009 therapist’s guide provides step-by-step instructions on how to implement NEAR techniques with patients to improve their cognitive functioning and quality of life. Guidelines are provided for setting up and running a successful cognitive remediation program. Therapists learn how to choose appropriate cognitive exercises, recruit and work with clients, perform intake interviews, and create treatment plans. This guide comes complete with all the tools necessary for facilitating treatment, including program evaluation forms and client handouts.

Intake and Assessment

2017 ◽  
pp. 75-90
Author(s):  
Alice Medalia ◽  
Tiffany Herlands ◽  
Alice Saperstein ◽  
Nadine Revheim
Keyword(s):  
Learning Style ◽  
Cognitive Training ◽  
Cognitive Skills ◽  
Treatment Plan ◽  
Treatment Strategies ◽  
Cognitive Remediation ◽  
Assessment Process ◽  
Educational Approach ◽  
Level Of Motivation ◽  
Cognitive Problems

The Neuropsychological Educational Approach to Remediation (NEAR) uses the intake and assessment process to evaluate cognitive skills and behaviors, to engage the client and formulate treatment strategies. As the first point of contact for the client coming to cognitive training in The Learning Center, the intake appointment provides an opportunity to engage the client in treatment by providing her with a positive first experience and identifying goals and motivation for cognitive training. The therapist gathers data during this appointment, including determining the client’s learning style, level of motivation, cognitive problems, personal interests, ability level, and recovery goals. This information provides the basis for an initial treatment plan and schedule of cognitive remediation sessions.

Phases of Treatment

2017 ◽  
pp. 123-140
Author(s):  
Alice Medalia ◽  
Tiffany Herlands ◽  
Alice Saperstein ◽  
Nadine Revheim
Keyword(s):  
Personal Growth ◽  
Cognitive Skills ◽  
Cognitive Remediation ◽  
Personal Goals ◽  
Learning Needs

Chapter 8 explains how the therapist can best prepare to guide cognitive remediation clients through the beginning, middle, and end phases of treatment. In each phase, the overarching goal of the therapist is to engage clients in the process of learning and create an environment that is conducive to cognitive and personal growth. This is accomplished by tailoring the introduction and progression of cognitive exercises and by employing techniques to motivate clients and meet the evolving learning needs of every individual throughout the course of intervention. When CR is successful, clients gain mastery over cognitive skills and strategies, strengthen their identity as independent learners, and progress toward achieving personal goals for recovery.

The Effect of Cognitive Remediation Therapy on Social Skills in Institutionalized Elderly Patients with Schizophrenia

2017 ◽  
Vol 12 (3) ◽  
pp. 182-186 ◽  
Author(s):  
Fatemeh Mohammadi ◽  
Yadollah Abolfathi Momtaz ◽  
Seyedeh Ameneh Motalebi ◽  
Shahnaz Boosepasi
Keyword(s):  
Social Skills ◽  
Elderly Patients ◽  
Behavioral Problems ◽  
Psychiatric Patients ◽  
Intervention Group ◽  
Cognitive Remediation ◽  
Control Group ◽  
Cognitive Remediation Therapy ◽  
Chi Square ◽  
Institutionalized Elderly

Background: There are limited scientific investigations on cognitive remediation in elderly patients with schizophrenia. The present study was aimed to examine the efficacy of cognitive remediation therapy on social skills in institutionalized elderly patients with schizophrenia. Methods: The study employed a randomized clinical trial. A total of 60 institutionalized elderly patients with schizophrenia from Razi Psychiatric Hospital, Tehran were selected and randomly allocated into two equal groups (control and intervention). The intervention group attended to cognitive remediation therapy for 8 weeks. The Evaluation of Living Skills Scale for psychiatric patients was used for data collection. The Chi Square, independent and paired t-tests using SPSS, version 22, were employed to analyze the data. Results: The mean age of 60 elderly patients participated in the study was 65.25 &#177; 4.19 years. No significant differences were found between two groups at baseline. However, independent t-tests showed significant differences between the intervention and the control group in social skills after implementation of intervention. Additionally, the results of paired t-tests revealed significant improvements in intervention group on communication skills (t=5.50, p<0.001), behavioral problems with others (t=5.44, p<0.001), and self-care (t=4.70, p<0.001). No significant differences were observed from pretest to post test in control group. Conclusion: The results of the present study may support the efficacy of cognitive remediation therapy on social skills of elderly patients with schizophrenia.

scholarly journals Structured Evaluation of Rehabilitation Programs Outcomes in Psychiatry: Application of a Recovery-Centered Model

2021 ◽  
Author(s):  
Simone Vanzetto ◽  
Matteo Zabotto ◽  
Federica Fasciana ◽  
Alberto Varinelli ◽  
Giovanna Cirnigliaro ◽  
...  
Keyword(s):  
Continuity Of Care ◽  
Psychosocial Functioning ◽  
Rating Scale ◽  
Psychiatric Patients ◽  
Evaluation Model ◽  
Rehabilitation Program ◽  
Wilcoxon Test ◽  
Global Functioning ◽  
Outcome Indicator ◽  
Indicator Model

AbstractRehabilitation is oriented to psychiatric patients’ recovery through specific techniques and structured projects, not yet fully standardized, carried out in territorial services. This study aims to apply an operational structured outcome indicator model (hospitalizations, continuity of care, LAI treatment adherence, working support) through a recovery-centered model in a rehabilitation community in Milan. This observational-retrospective study included 111 patients from a University High Assistance Rehabilitation Community (C.R.A.) based in Milan. Psychopathological and psychosocial functioning was evaluated with Kennedy Axis V, Brief Psychiatric Rating Scale (BPRS), Life Skills Profile (LSP), AR module of the VADO scale. Statistical analyses were performed using SPSS software version 19. Student t test and Wilcoxon Test were used to analyze quantitative variables, while McNemar test for qualitative variables. The minimum level of significance was set at 0.05 (p <0.05). The results showed that CRA rehabilitation program led to significant improvement in global functioning in terms of hospitalization reduction; improved continuity of care; stable adherence to psychopharmacological treatment with Long Acting Injectable (LAI) antipsychotics; stable employment maintenance during the year following discharge from the CRA. This study confirmed the utility of a structured outcome indicator model and highlighted its feasibility in daily clinical context of a rehabilitative community. Our results supported the effectiveness of a community-based rehabilitation program to improve individual functioning and clinical stability. However, further studies are required to better achieve the development of a recovery-oriented rehabilitation model and rigorously define an outcomes evaluation model.

Nonclinical Core Competencies and Effects of Interprofessional Teamwork in Disaster and Emergency Response Training and Practice: A Pilot Study

2013 ◽  
Vol 7 (4) ◽  
pp. 395-402 ◽  
Author(s):  
Jennifer Peller ◽  
Brian Schwartz ◽  
Simon Kitto
Keyword(s):  
Cognitive Skills ◽  
Disaster Response ◽  
Interprofessional Collaboration ◽  
Core Competencies ◽  
Evidence Base ◽  
Response Data ◽  
Competency Training ◽  
Interprofessional Teamwork ◽  
The Relationship ◽  
Depth Interviews

AbstractObjectiveTo define and delineate the nontechnical core competencies required for disaster response, Disaster Medical Assistance Team (DMAT) members were interviewed regarding their perspectives and experiences in disaster management. Also explored was the relationship between nontechnical competencies and interprofessional collaboration.MethodsIn-depth interviews were conducted with 10 Canadian DMAT members to explore how they viewed nontechnical core competencies and how their experiences influenced their perceptions toward interprofessonalism in disaster response. Data were examined using thematic analysis.ResultsNontechnical core competencies were categorized under austere skills, interpersonal skills, and cognitive skills. Research participants defined interprofessionalism and discussed the importance of specific nontechnical core competencies to interprofessional collaboration.ConclusionsThe findings of this study established a connection between nontechnical core competencies and interprofessional collaboration in DMAT activities. It also provided preliminary insights into the importance of context in developing an evidence base for competency training in disaster response and management. (Disaster Med Public Health Preparedness. 2013;0:1–8)

scholarly journals The Implementation and Review of Cognitive Remediation Training for First Episode Psychosis in Singapore

2021 ◽  
Vol 12 ◽  
Author(s):  
Nigel Ian Ming Chong ◽  
Yogeswary Maniam ◽  
Yi Chian Chua ◽  
Charmaine Tang
Keyword(s):  
Verbal Memory ◽  
Cognitive Abilities ◽  
Statistical Significance ◽  
Real Life ◽  
Cognitive Remediation ◽  
First Episode Psychosis ◽  
Early Psychosis ◽  
First Episode ◽  
Educational Approach ◽  
Episode Psychosis

Objective: Early intervention in patients with first episode psychosis (FEP) can improve cognitive abilities, with both short- and long-term benefits. In this paper, we describe the implementation and review of cognitive remediation training (CRT) in an Asian FEP population. The outcomes of the training are also evaluated and discussed.Methods: This naturalistic paper describes in detail the real-life implementation and conduct of CRT in an early psychosis intervention service. One hundred and nine patients with FEP underwent a 24-session CRT programme, using Cogpack and Neuropsychological Educational Approach to Remediation. The program is evaluated with pre- and post-CRT assessment scores which included Montreal Cognitive Assessment and Brief Assessment of Cognition in Schizophrenia. The rates of improvement on these cognitive assessments were evaluated using paired t-tests, with statistical significance set at p ≤ 0.05.Results: Of the 109 patients who underwent CRT, a total of 92 (84.4%) completed all 24 sessions. Paired t-tests between pre- and post-CRT assessments scores revealed that participants significantly improved on majority of the measures, including verbal memory, digit sequencing, and symbol coding.Conclusion: As with other cognitive remediation programmes, CRT has shown to improve cognitive functioning in patients with FEP. The results support the use of CRT in an Asian context and may serve as guidance for the implementation of similar training programmes in other Asian early psychosis intervention services.

Empowering Students in Computer-Supported Education

2012 ◽  
pp. 198-207 ◽  
Author(s):  
Yongming Shi ◽  
Si Fan ◽  
Yun Yue
Keyword(s):  
Teaching And Learning ◽  
Learning Theories ◽  
Traditional Learning ◽  
Learning Needs ◽  
Web Based ◽  
Individualized Learning ◽  
Learning And Teaching ◽  
Learner Centred Learning ◽  
Computer Based ◽  
Supported Education

In the past two decades, computers and web-based technologies have created a computer-based focus in the field of education. The computer-supported teaching and learning has revolutionised the concept of education around the world, which creates both opportunities and challenges in the field of education. It is believed that computer-based technologies have developed to augment the traditional learning and teaching at all educational levels. Computer-supported education empowers learners by promoting the notions of learner-centred learning approach, encouraging interactions among students or between students and lecturer, and addressing the individualized learning needs. This chapter explains some important concepts in computer-supported education, and presents the learning theories that underpin this area. Furthermore, it discusses the benefits of web-based technologies for students at various levels and issues that require further research.

Treatment Planning

2017 ◽  
pp. 91-110
Author(s):  
Alice Medalia ◽  
Tiffany Herlands ◽  
Alice Saperstein ◽  
Nadine Revheim
Keyword(s):  
Treatment Planning ◽  
Learning Style ◽  
Treatment Plan ◽  
Cognitive Remediation ◽  
Educational Approach ◽  
Frustration Tolerance ◽  
Case Examples ◽  
Time Treatment ◽  
Treatment Plans ◽  
Over Time

Chapter 6 describes how to use treatment plans to guide cognitive remediation sessions. Personalized treatment planning takes into account the multiple factors unique to each client that impact how they use cognition in everyday life. Neuropsychological Educational Approach to Remediation (NEAR) treatment plans address current cognitive deficits, the client’s need for structure, motivation and goals, learning style and barriers, endurance, frustration tolerance, approach to tasks, and task repertoire. The treatment plan should be updated periodically because each of these factors may change over time. Treatment plan components are reviewed, and case examples are provided.

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