Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up.
Neurocognitive enhancement therapy (NET) is a remediation program for the persistent and function-limiting cognitive impairments of schizophrenia. In a previous study in veterans, NET improved work therapy outcomes as well as executive function and working memory. The present study aimed to determine whether NET could enhance functional outcomes among schizophrenia and schizoaffective patients in a community mental health center receiving community-based vocational services.


METHODS
Patients (N=72) participated in a hybrid transitional and supported employment program (VOC) and were randomized to either NET+VOC or VOC only. NET+VOC included computer-based cognitive training, work feedback and a social information information-processing group. VOC only also included two weekly support groups. Active intervention was 12 months with 12 month follow-up. Follow-up rate was 100%.


RESULTS
NET+VOC patients worked significantly more hours during the 12 month follow-up period, reached a significantly higher cumulative rate of competitive employment by the sixth quarter, and maintained significantly higher rates of employment.


CONCLUSIONS
NET training improved vocational outcomes, suggesting the value of combining cognitive remediation with other rehabilitation methods to enhance functional outcomes.
Bell
Morris D
MD
VA Connecticut Healthcare System, Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA. Bell.Morris_D+@West-Haven.VA.Gov
Zito
Wayne
W
Greig
Tamasine
T
Wexler
Bruce E
BE
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D004651:Employment; D016832:Employment, Supported; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009788:Occupational Therapy; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group; D011618:Psychotic Disorders / Q000523:psychology / Q000534:rehabilitation; D012050:Rehabilitation, Vocational / Q000379:methods*; D012559:Schizophrenia / Q000175:diagnosis / Q000534:rehabilitation* / Q000628:therapy; D012565:Schizophrenic Psychology; D016896:Treatment Outcome; D014829:Vocational Education