title: Cognitive Enhancement Treatment for People With Mental Illness Who Do Not Respond to Supported Employment: A Randomized Controlled Trial.
abstract: OBJECTIVE
  Cognitive impairment presents a serious and common obstacle to competitive employment for people with severe mental illness, including those who receive supported employment. This study evaluated a cognitive enhancement program to improve cognition and competitive employment in people with mental illness who had not responded to supported employment.
  
  
  METHODS
  In a randomized controlled trial, 107 people with severe mental illness (46% with schizophrenia or schizoaffective disorder) who had not obtained or kept competitive work despite receiving high-fidelity supported employment were assigned to receive either enhanced supported employment (with specialized cognitive training of employment specialists) or enhanced supported employment plus the Thinking Skills for Work program, a standardized cognitive enhancement program that includes practice of computer cognitive exercises, strategy coaching, and teaching of coping and compensatory strategies. Research assistants tracked competitive employment weekly for 2 years, and assessors blind to treatment assignment evaluated cognitive functioning at baseline, at the end of cognitive enhancement training, and 12 and 24 months after baseline.
  
  
  RESULTS
  Participants in the Thinking Skills for Work group improved more than those in the enhanced supported employment only group on measures of cognitive functioning and had consistently better competitive employment outcomes during the follow-up period, including in jobs obtained (60% compared with 36%), weeks worked (23.9 compared with 9.2), and wages earned ($3,421 compared with $1,728).
  
  
  CONCLUSIONS
  The findings suggest that cognitive enhancement interventions can reduce cognitive impairments that are obstacles to work, thereby increasing the number of people who can benefit from supported employment and competitive work.
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Susan R
authors.initials: SR
authors.lastname: McGurk
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Kim T
authors.initials: KT
authors.lastname: Mueser
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Haiyi
authors.initials: H
authors.lastname: Xie
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Jason
authors.initials: J
authors.lastname: Welsh
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Susan
authors.initials: S
authors.lastname: Kaiser
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Drake
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Becker
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Edward
authors.initials: E
authors.lastname: Bailey
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Ginnie
authors.initials: G
authors.lastname: Fraser
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Rosemarie
authors.initials: R
authors.lastname: Wolfe
authors.affiliation: From the Center for Psychiatric Rehabilitation, Boston University, Boston.
authors.forename: Gregory J
authors.initials: GJ
authors.lastname: McHugo
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000628:therapy*; D016832:Employment, Supported / Q000523:psychology*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D013850:Thinking