Extensions of errorless learning for social problem-solving deficits in schizophrenia.
OBJECTIVE
There is a clear need to develop psychosocial rehabilitation methods that compensate for neurocognitive deficits common to persons with severe and persistent mental illness. Errorless learning, a compensatory training intervention, has been successful in teaching entry-level job tasks. However, errorless learning's applicability to broader, more complex functions is unknown. The present study tested the extension of errorless learning for deficits in social problem-solving skills in patients with schizophrenia.


METHODS
Sixty clinically stable outpatients with schizophrenia or schizoaffective disorder were stratified by gender and level of memory impairment before being randomly assigned to one of two training programs: errorless learning or symptom management. Groups were matched for training time, format and structure of training, and types of teaching aids used. Social problem-solving ability, measured by the Assessment of Interpersonal Problem-Solving Skills, was assessed at baseline, within 2 days of training completion, and after 3 months. Dependent measures were the scores for the receiving, processing, and sending skills areas from the Assessment of Interpersonal Problem-Solving Skills.


RESULTS
A repeated-measures analysis of covariance was conducted for each dependent measure with baseline Assessment of Interpersonal Problem-Solving Skills score entered as a covariate. For all three skills, there was a significant training group effect favoring errorless learning. Durability of errorless learning training effects extended to the 3-month follow-up assessment for processing and sending skills but not receiving skills.


CONCLUSIONS
Results support the extension of errorless learning to complex functions such as social problem-solving skills in the rehabilitation of persons with schizophrenia.
Kern
Robert S
RS
Department of Psychiatry and Biobehavioral Sciences, UCLA Neuropsychiatric Institute and Hospital, Los Angeles, CA, USA. rkern@ucla.edu
Green
Michael F
MF
Mitchell
Sharon
S
Kopelowicz
Alex
A
Mintz
Jim
J
Liberman
Robert P
RP
D000328:Adult; D000553:Ambulatory Care; D001521:Behavior Therapy / Q000379:methods; D003072:Cognition Disorders / Q000523:psychology / Q000534:rehabilitation* / Q000628:therapy; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D007858:Learning; D008297:Male; D008569:Memory Disorders / Q000523:psychology / Q000534:rehabilitation / Q000628:therapy; D010056:Overlearning; D011214:Practice, Psychological; D011340:Problem Solving; D012056:Reinforcement, Social; D012559:Schizophrenia / Q000534:rehabilitation* / Q000628:therapy; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D013663:Teaching / Q000379:methods*; D016896:Treatment Outcome