title: Effects of integrated supported employment plus cognitive remediation training for people with schizophrenia and schizoaffective disorders.
abstract: OBJECTIVE
  The present study aims to investigate the synergistic effects of cognitive remediation training (CRT) on Integrated Supported Employment (ISE). ISE blends individual placement support service with work-related social skills training for Chinese people suffering from schizophrenia or schizoaffective disorder.
  
  
  METHODS
  Ninety participants with schizophrenia or schizoaffective disorders were recruited from two psychiatric outpatient services in Hong Kong. They were randomly assigned into the ISE+CRT (n=45) and ISE (n=45) conditions. Blinded assessments on vocational, clinical, psychological, and neurocognitive outcomes were conducted by independent assessors. The two groups were followed up at 7 and 11months.
  
  
  RESULTS
  Both groups yielded similar improvements across several outcome domains assessed immediately after the interventions and at 7 and 11month follow-ups, but no significant group differences were found. Significant positive trends over time in vocational, clinical and cognitive outcomes consistently favored the ISE+CRT condition.
  
  
  CONCLUSIONS
  While both the ISE+CRT and ISE groups demonstrated improvement in vocational, clinical, psychological, and neurocognitive outcomes, there was no evidence to show that cognitive remediation facilitated further improvement in these domains beyond gains associated with ISE alone. Further investigation is needed to fully exploit the synergistic potential of ISE combined with CRT, and to better understand which individuals experience a maximal benefit from the specific rehabilitation program components.
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Doreen W H
authors.initials: DW
authors.lastname: Au
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong. Electronic address: hector.tsang@polyu.edu.hk.
authors.forename: Hector W H
authors.initials: HW
authors.lastname: Tsang
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Wendy W Y
authors.initials: WW
authors.lastname: So
authors.affiliation: Department of Psychiatry, School of Medicine, Yale University, United States.
authors.forename: Morris D
authors.initials: MD
authors.lastname: Bell
authors.affiliation: Neuropsychiatric Rehabilitation Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Vinci
authors.initials: V
authors.lastname: Cheung
authors.affiliation: Department of Psychiatry, United Christian Hospital, Hong Kong.
authors.forename: Michael G C
authors.initials: MG
authors.lastname: Yiu
authors.affiliation: Department of Psychiatry, United Christian Hospital, Hong Kong.
authors.forename: K L
authors.initials: KL
authors.lastname: Tam
authors.affiliation: Department of Psychiatry, United Christian Hospital, Hong Kong.
authors.forename: Gary Tin-ho
authors.initials: GT
authors.lastname: Lee
mesh_terms: D000328:Adult; D003071:Cognition; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D016832:Employment, Supported / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011618:Psychotic Disorders / Q000523:psychology / Q000628:therapy*; D012050:Rehabilitation, Vocational / Q000379:methods*; D012559:Schizophrenia / Q000628:therapy*; D012565:Schizophrenic Psychology; D066107:Social Skills; D016896:Treatment Outcome; D014478:Unemployment
keywords: Cognitive remediation training; Integrated supported employment; Schizophrenia; Vocational rehabilitation; Work-related social skills training