Training schizophrenics to talk to themselves: A means of developing attentional controls

Meichenbaum, Donald; Cameron, Roy

doi:10.1016/s0005-7894(73)80003-6

Cited by 242 publications

(99 citation statements)

References 30 publications

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“…Two such issues deserve special consideration: the evaluation of the persistence of remediation effects on cognitive functioning and the assessment of the impact of remediation on functional outcomes. Despite the number of controlled studies of cognitive remediation, only six studies (16,19,21,(28)(29)(30) examined whether improvements in cognitive functioning were maintained at a posttreatment follow-up, precluding the exploration of moderators of treatment effects. The relative lack of data addressing this question may be important because different program, patient, or setting factors could influence the long-term maintenance of cognitive effects compared to short-term effects.…”

Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

“…When a study reported data from multiple measures classified in the same cognitive domain, the mean of the effect sizes from those measures was used. Effect size distributions were evaluated for outliers, resulting in exclusion of results of one study from the functional outcome analyses (16).…”

Section: Calculation Of Effect Sizesmentioning

confidence: 99%

“…Despite the number of controlled studies of cognitive remediation, only six studies (16,19,21,(28)(29)(30) examined whether improvements in cognitive functioning were maintained at a posttreatment follow-up, precluding the exploration of moderators of treatment effects. The relative lack of data addressing this question may be important because different program, patient, or setting factors could influence the long-term maintenance of cognitive effects compared to short-term effects.Similarly, only 11 studies evaluated functional outcomes (16,19,20,22,24,25,27,29,(42)(43)(44), and this was the first meta-analysis to quantitatively demonstrate that cognitive remediation improved psychosocial functioning. Furthermore, the impact of cognitive remediation on functioning was moderated by several factors, including the provision of adjunctive psychiatric rehabilitation, cognitive training method, and patient age, suggesting potentially important factors for improving the impact of treatment programs.…”

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confidence: 99%

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A Meta-Analysis of Cognitive Remediation in Schizophrenia

McGurk¹,

Twamley²,

Sitzer³

et al. 2007

AJP

1,052

830

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Objective-This study evaluated the effects of cognitive remediation for improving cognitive performance, symptoms, and psychosocial functioning in schizophrenia.Method-A meta-analysis was conducted of 26 randomized, controlled trials of cognitive remediation in schizophrenia including 1,151 patients.Results-Cognitive remediation was associated with significant improvements across all three outcomes, with a medium effect size for cognitive performance (0.41), a slightly lower effect size for psychosocial functioning (0.36), and a small effect size for symptoms (0.28). The effects of cognitive remediation on psychosocial functioning were significantly stronger in studies that provided adjunctive psychiatric rehabilitation than in those that provided cognitive remediation alone.Conclusions-Cognitive remediation produces moderate improvements in cognitive performance and, when combined with psychiatric rehabilitation, also improves functional outcomes.Cognitive impairment is a core feature of schizophrenia, with converging evidence showing that it is strongly related to functioning in areas such as work, social relationships, and independent living (1, 2). Furthermore, cognitive functioning is a robust predictor of response to psychiatric rehabilitation (i.e., systematic efforts to improve the psychosocial functioning of persons with severe mental illness) (3), including outcomes such as work, social skills, and self-care (1,4,5). Because of the importance of cognitive impairment in schizophrenia, it has been identified as an appropriate target for interventions (6).Currently available pharmacological treatments have limited effects on cognition in schizophrenia (7,8) and even less impact on community functioning (9). To address the problem of cognitive impairment in schizophrenia, a range of cognitive remediation programs has been developed and evaluated over the past 40 years. These programs employ a variety of methods, such as drill and practice exercises, teaching strategies to improve cognitive functioning, compensatory strategies to reduce the effects of persistent cognitive impairments, and group discussions. Several reviews of research on cognitive rehabilitation in schizophrenia have been published (10-13). The general conclusions from these reviews have been that cognitive remediation NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript leads to modest improvements in performance on neuropsychological tests but has no impact on functional outcomes. However, these reviews were limited by the relatively small number of studies that actually measured psychosocial functioning, precluding any definitive conclusions about the effects of cognitive remediation on psychosocial adjustment or the identification of program characteristics that may contribute to such effects. The rationale for cognitive remediation is chiefly predicated on its presumed effects on psychosocial functioning and improved response to rehabilitation. Therefore, a critical examination of the effects of cognitive ...

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Section: Nih-pa Author Manuscriptmentioning

confidence: 99%

Section: Calculation Of Effect Sizesmentioning

confidence: 99%

mentioning

confidence: 99%

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A Meta-Analysis of Cognitive Remediation in Schizophrenia

McGurk¹,

Twamley²,

Sitzer³

et al. 2007

AJP

1,052

830

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“…Meichenbaum, 1969;Meichenbaum & Cameron, 1973). Coaching may also include procedures intended to help the patient develop a meta-cognitive perspective on the task, i.e.…”

Section: Neuropsychological Therapy (Npt): a Description Of The Approachmentioning

confidence: 99%

Psychological Treatment of Psychosis

Haddock¹,

Spaulding²

2010

Schizophrenia

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Psychological treatments for the treatment of psychosis have been widely studied over many years. Early studies were mainly in the form of individual case studies or case series. However, more recently, treatments have been evaluated in larger, controlled trials leading to a larger evidence base on which to judge their effectiveness for psychosis. This evidence bases suggests that certain approaches can be effective in reducing the severity and distress associated with psychosis and some of these have become more widely employed in the treatment of severe mental health problems over the last decade in the United Kingdom, Europe and the United States. Generally, the treatments with the greatest evidence base are in following treatment domains: 1) individual cognitive and behavioural therapies for psychosis, 2) family interventions for psychosis, 3) neuropsychological and cognitive remediation approaches, 4) social skills training and other skills training approaches and 5) contingency management approaches. Characteristics of the approaches are described, (using clinical examples) and evidence in support of their effectiveness is presented. The implications for applying the approaches with complex cases, such as those with dual diagnoses is described. Finally, the challenges facing services in implementing the approaches is discussed.

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“…Therefore, each exercise in Reha-bil program has 5 levels that differ in terms of Dear Editor, Cognitive remediation therapy (CRT) dates back to 1970s (Meichenbaum and Cameron 1973) and since then it is used for the rehabilitation of the cognitive disfunctioning of several clinical conditions such as schizophrenia (Kluwe-Schiavon et al, 2013;Anaya et al, 2012), mood disorders (Bowie et al, 2013) eating disorders (Tchanturia and Lock, 2011), brain tumor related cognitive deficits (Sacks-Zimmerman et al, 2015) and attention deficits (Wender et al, 2001). …”

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confidence: 99%

Cognitive Remediation Therapy Toolbox Development for Turkish Population

Kaşıkçı¹,

Taş²

2017

JNBS

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LETTER TO THE EDITORcomputer-based versions, we developed a CRT toolbox suitable for local culture.Reha-bil exercises were developed focusing on some main cognitive functions such as attention, memory, decision making, visiospatial abilities and their sub categories: sustained attention, selective attention, shortterm memory, working memory, planning, alternating attention, impulse inhibition. For each sub-category, our team had brain storming sessions for finding an original computer-game idea with which the use of that specific cognitive function will be needed and several strategies about the effective use of that function can be discussed. Another major indicator of the game creation process was it is relevance of daily life situations. We created probably scenarios for the exercises such as selecting the rotten fruits from several others, preparing the order of the customer in a fast-food restaurant. By this way we came up with 20 original exercises, all with 5 levels of difficulty and can easily be related to daily-life conditions. The exercises were designed in 3D using Unity 3D game engine. After developing the exercises, we came up with a 16 session CRT program.Scaffolding, massed practice, errorless learning, positive reinforcement are the main techniques that are used in CRT application and we embedded all these techniques in our exercises.

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Training schizophrenics to talk to themselves: A means of developing attentional controls

Cited by 242 publications

References 30 publications

A Meta-Analysis of Cognitive Remediation in Schizophrenia

A Meta-Analysis of Cognitive Remediation in Schizophrenia

Psychological Treatment of Psychosis

Cognitive Remediation Therapy Toolbox Development for Turkish Population

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