title: Testing a modification of cognitive adaptation training: streamlining the model for broader implementation.
abstract: Cognitive adaptation training (CAT) is a home-based, manualized treatment that utilizes environmental supports to improve target behaviors and functional outcomes in persons with schizophrenia. Although clinical trials have shown CAT to be effective across functional, clinical, and treatment adherence domains, when the intervention is withdrawn clients experience significant declines. The aim of the current study was to test a modified version of CAT, which decreases the duration of intensive CAT intervention while utilizing ongoing case management-supported CAT to maintain the fundamental components of the treatment. Twenty-three people participated in an outcome study of the modified version of CAT, evaluating improvements after 4months of CAT specialist intervention and after an additional 5months of case manager support. Analysis revealed significant improvements in adaptive functioning, psychiatric symptomatology, and goal attainment, which were maintained throughout case management follow-up. This suggests that an intervention that has previously demonstrated good functional outcomes in randomized trials might sustain its impacts in an abbreviated format with support from existing case managers.
authors.affiliation: University of Toronto, Department of Psychiatry, Canada. Electronic address: sean_kidd@camh.net.
authors.forename: Sean A
authors.initials: SA
authors.lastname: Kidd
authors.affiliation: Toronto Centre for Addiction and Mental Health, 1001 Queen St. W., Toronto, Ontario, Canada, M6J 1H1.
authors.forename: Yarissa
authors.initials: Y
authors.lastname: Herman
authors.affiliation: Toronto Centre for Addiction and Mental Health, 1001 Queen St. W., Toronto, Ontario, Canada, M6J 1H1.
authors.forename: Skye
authors.initials: S
authors.lastname: Barbic
authors.affiliation: University of Toronto, Department of Psychiatry, Canada.
authors.forename: Rohan
authors.initials: R
authors.lastname: Ganguli
authors.affiliation: University of Toronto, Department of Psychiatry, Canada.
authors.forename: Tony P
authors.initials: TP
authors.lastname: George
authors.affiliation: Toronto Centre for Addiction and Mental Health, 1001 Queen St. W., Toronto, Ontario, Canada, M6J 1H1.
authors.forename: Sabrina
authors.initials: S
authors.lastname: Hassan
authors.affiliation: University of Toronto, Department of Psychiatry, Canada.
authors.forename: Kwame
authors.initials: K
authors.lastname: McKenzie
authors.affiliation: University of Texas, San Antonio, Department of Psychiatry, 7703 Floyd Curl Dr, San Antonio, TX 78229, United States.
authors.forename: Natalie
authors.initials: N
authors.lastname: Maples
authors.affiliation: University of Texas, San Antonio, Department of Psychiatry, 7703 Floyd Curl Dr, San Antonio, TX 78229, United States.
authors.forename: Dawn
authors.initials: D
authors.lastname: Velligan
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000534:rehabilitation*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
keywords: Cognition; Cognitive adaptation training; Functioning; Outcome; Schizophrenia