Cognitive Remediation: A New Generation of Psychosocial Interventions for People with Schizophrenia

Abstract

Schizophrenia is a mental health condition characterized by broad impairments in cognition, which place profound limitations on functional recovery. Social work has an enduring legacy in pioneering the development of novel psychosocial interventions for people with schizophrenia, and this article introduces cognitive remediation, the latest advance in psychosocial treatments for the disorder designed to improve cognition. First, an overview of the nature of cognitive impairments and their functional consequences in schizophrenia is presented, followed by a description of the theoretical basis and key practice principles of cognitive remediation. Next, the latest biopsychosocial evidence for the efficacy of cognitive remediation in schizophrenia is critically reviewed. Finally, a model cognitive remediation program, Cognitive Enhancement Therapy, which was developed and evaluated by a social work-led multidisciplinary team is presented. Cognitive Enhancement Therapy represents a significant advance in cognitive remediation for schizophrenia, and uses a unique holistic approach that extends beyond traditional neurocognitive training to facilitate the achievement of adult social-cognitive milestones and broader functional recovery. It is concluded that cognitive remediation represents an effective next generation of psychosocial interventions that social workers can use to help improve the lives of many people who live with schizophrenia.

Effectiveness of Social Skills Training Program on Social Functioning and Severity of Symptoms Among Patients with Schizophrenia

“…work, spouse) or to have needs met. The unavoidable effect of schizophrenia across perceptual, cognitive, emotional and behavioral domains, additionally the heterogeneity within those domains requires a multi modal and comprehensive approach to treatment and rehabilitation which involves the individual and his or her environment [8]. Social skills training, has demonstrated effectiveness in yielding skill acquisition durability, and generalization and has been recognized as a psychosocial treatment of choice for schizophrenia.…”

Cognitive Remediation for Schizophrenia: A Review of Recent Findings

“…Several studies support the implementation of CR in real-world clinical settings [17,20,21,44], although there remains uncertainty about the specific parameters of implementation (e.g., duration, approach, dosage, etc.). As stated above, computerized programs can ease the burden of dissemination in that they require less staff training, and enhance standardization of procedures.…”

Recovery from Diffuse Brain Injuries: Two Case Studies

“…Cognitive remediation was adapted from work with individuals with traumatic brain injury and stroke [50,51]. Therapy techniques specifically focused on memory deficits, concentration issues, difficulty with daily living skills, irritability, impatience, dependence on others including use of: (a) cueing; (b) fading; (c) use of hierarchical targets; (d) anchoring; (e) repeated practice; and/or, (f) use of strategies [50]. Both patients have returned to work and have not received therapy after a period of 5 years.…”