Skip to main content
Top
Published in: Current Psychiatry Reports 4/2010

01-08-2010

Vocational, Social, and Cognitive Rehabilitation for Individuals Diagnosed With Schizophrenia: A Review of Recent Research and Trends

Authors: Seth Kurzban, Lisa Davis, John S. Brekke

Published in: Current Psychiatry Reports | Issue 4/2010

Login to get access

Abstract

A growing body of evidence suggests that social and vocational interventions effectively enhance social and vocational functioning for individuals with schizophrenia. In this review, we first consider recent advances in vocational and social rehabilitation, then examine current findings on neurocognition, social cognition, and motivation with regard to the impact these elements have on rehabilitation interventions and outcomes. A critical evaluation of recent studies examining standalone treatment approaches and hybrid approaches that integrate components such as cognitive remediation and skills training reveals several ongoing challenges within the field. Greater understanding of the differential impact of various approaches, methods that may increase the magnitude of treatment effects, and the generalization of treatment effects to community functioning are among crucial areas for future research. Overall, these treatments hold promise in improving psychosocial functioning and helping individuals with schizophrenia acquire important life skills.
Literature
1.
go back to reference • Bellack AS, Green MF, Cook JA, et al.: Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop. Schizophr Bull 2007, 33:805–822. The article reports recent progress in developing interventions targeting impairments in community functioning for people with schizophrenia. The National Institute of Mental Health convened a workgroup to address inconsistencies in measuring functional outcomes, and the authors provide recommendations regarding standard assessment in this area.CrossRefPubMed • Bellack AS, Green MF, Cook JA, et al.: Assessment of community functioning in people with schizophrenia and other severe mental illnesses: a white paper based on an NIMH-sponsored workshop. Schizophr Bull 2007, 33:805–822. The article reports recent progress in developing interventions targeting impairments in community functioning for people with schizophrenia. The National Institute of Mental Health convened a workgroup to address inconsistencies in measuring functional outcomes, and the authors provide recommendations regarding standard assessment in this area.CrossRefPubMed
2.
go back to reference Pratt SI, Van Citters AD, Mueser KT, Bartels SJ: Psychosocial rehabilitation in older adults with serious mental illness: a review of the research literature and recommendations for development of rehabilitative approaches. Am J Psychiatr Rehabil 2008, 11:7–40.CrossRef Pratt SI, Van Citters AD, Mueser KT, Bartels SJ: Psychosocial rehabilitation in older adults with serious mental illness: a review of the research literature and recommendations for development of rehabilitative approaches. Am J Psychiatr Rehabil 2008, 11:7–40.CrossRef
3.
go back to reference • Kern RS, Glynn SM, Horan WP, Marder SR: Psychosocial treatments to promote functional recovery in schizophrenia. Schizophr Bull 2009, 35:347–361. In this recently published review, the authors critically examine a wide range of interventions that promote functional recovery in schizophrenia. They also provide an evaluation of the interaction between pharmacologic and psychosocial treatments in relationship to functional recovery in schizophrenia.CrossRefPubMed • Kern RS, Glynn SM, Horan WP, Marder SR: Psychosocial treatments to promote functional recovery in schizophrenia. Schizophr Bull 2009, 35:347–361. In this recently published review, the authors critically examine a wide range of interventions that promote functional recovery in schizophrenia. They also provide an evaluation of the interaction between pharmacologic and psychosocial treatments in relationship to functional recovery in schizophrenia.CrossRefPubMed
4.
go back to reference Bond GR, Campbell K: Evidence-based practices for individuals with severe mental illness. J Rehabil 2008, 74:33–43. Bond GR, Campbell K: Evidence-based practices for individuals with severe mental illness. J Rehabil 2008, 74:33–43.
5.
go back to reference Bond GR, Becker DR, Drake RE, et al.: Implementing supported employment as an evidence-based practice. Psychiatr Serv 2001, 52:313–322.CrossRefPubMed Bond GR, Becker DR, Drake RE, et al.: Implementing supported employment as an evidence-based practice. Psychiatr Serv 2001, 52:313–322.CrossRefPubMed
6.
go back to reference Cook JA, Lehman AF, Drake R, et al.: Integration of psychiatric and vocational services: a multisite randomized, controlled trial of supported employment. Am J Psychiatry 2005, 162:1948–1956.CrossRefPubMed Cook JA, Lehman AF, Drake R, et al.: Integration of psychiatric and vocational services: a multisite randomized, controlled trial of supported employment. Am J Psychiatry 2005, 162:1948–1956.CrossRefPubMed
7.
go back to reference Killackey E, Jackson HJ, McGorry PD: Vocational intervention in first-episode psychosis: individual placement and support v. treatment as usual. Br J Psychiatry 2008, 193:114–120.CrossRefPubMed Killackey E, Jackson HJ, McGorry PD: Vocational intervention in first-episode psychosis: individual placement and support v. treatment as usual. Br J Psychiatry 2008, 193:114–120.CrossRefPubMed
8.
go back to reference Wu EQ, Birnbaum HG, Shi L, et al.: The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry 2005, 66:1122–1129.CrossRefPubMed Wu EQ, Birnbaum HG, Shi L, et al.: The economic burden of schizophrenia in the United States in 2002. J Clin Psychiatry 2005, 66:1122–1129.CrossRefPubMed
9.
go back to reference Leff J, Warner R: Social Inclusion of People With Mental Illness. Cambridge, United Kingdom: Cambridge University Press; 2006.CrossRef Leff J, Warner R: Social Inclusion of People With Mental Illness. Cambridge, United Kingdom: Cambridge University Press; 2006.CrossRef
10.
go back to reference •• Drake RE, Bond GR: The future of supported employment for people with severe mental illness. Psychiatr Rehabil J 2008, 31:367–376. This review examines current research on the effectiveness of supported employment and efforts aimed at the dissemination of the intervention. Key areas for future research that are discussed include financing of services, motivation, and illness-related barriers to improving vocational outcomes.CrossRefPubMed •• Drake RE, Bond GR: The future of supported employment for people with severe mental illness. Psychiatr Rehabil J 2008, 31:367–376. This review examines current research on the effectiveness of supported employment and efforts aimed at the dissemination of the intervention. Key areas for future research that are discussed include financing of services, motivation, and illness-related barriers to improving vocational outcomes.CrossRefPubMed
11.
go back to reference Shean GD: Evidence-based psychosocial practices in recovery from schizophrenia. Psychiatry 2009, 72:307–320.PubMed Shean GD: Evidence-based psychosocial practices in recovery from schizophrenia. Psychiatry 2009, 72:307–320.PubMed
12.
go back to reference Bond GR, Drake RE, Becker DR: An update on randomized controlled trials of evidence-based supported employment. Psychiatr Rehabil J 2008, 31:280–290.CrossRefPubMed Bond GR, Drake RE, Becker DR: An update on randomized controlled trials of evidence-based supported employment. Psychiatr Rehabil J 2008, 31:280–290.CrossRefPubMed
13.
go back to reference Twamley EW, Narvaez JM, Becker DR, et al.: Supported employment for middle-aged and older people with schizophrenia. Am J Psychiatr Rehabil 2008, 11:76–89.CrossRefPubMed Twamley EW, Narvaez JM, Becker DR, et al.: Supported employment for middle-aged and older people with schizophrenia. Am J Psychiatr Rehabil 2008, 11:76–89.CrossRefPubMed
14.
go back to reference Becker DR, Drake RE: Individual placement and support: a community mental health center approach to vocational rehabilitation. Community Ment Health J 1994, 30:193–206.CrossRefPubMed Becker DR, Drake RE: Individual placement and support: a community mental health center approach to vocational rehabilitation. Community Ment Health J 1994, 30:193–206.CrossRefPubMed
15.
go back to reference •• Burns T, Catty J, White S, et al.: The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support. Schizophr Bull 2009, 35:949–958. This multinational study found that people with severe mental illness receiving IPS had better global functioning than those receiving general vocational rehabilitation at 18-month follow-up. Importantly, the authors found that IPS was better than the control condition at improving the outcomes of more severely impaired participants.CrossRefPubMed •• Burns T, Catty J, White S, et al.: The impact of supported employment and working on clinical and social functioning: results of an international study of individual placement and support. Schizophr Bull 2009, 35:949–958. This multinational study found that people with severe mental illness receiving IPS had better global functioning than those receiving general vocational rehabilitation at 18-month follow-up. Importantly, the authors found that IPS was better than the control condition at improving the outcomes of more severely impaired participants.CrossRefPubMed
16.
go back to reference •• Horan WP, Kern RS, Green MF, Penn DL: Social cognition training for individuals with schizophrenia: emerging evidence. Am J Psychiatr Rehabil 2008, 11:205–252. In this recent review, the authors critically examine studies investigating the modifiability of social cognition in schizophrenia. Evidence pertaining to brief social cognitive manipulations and longer-term social cognitive training suggests that certain treatments enhance functioning across multiple domains of social cognition.CrossRef •• Horan WP, Kern RS, Green MF, Penn DL: Social cognition training for individuals with schizophrenia: emerging evidence. Am J Psychiatr Rehabil 2008, 11:205–252. In this recent review, the authors critically examine studies investigating the modifiability of social cognition in schizophrenia. Evidence pertaining to brief social cognitive manipulations and longer-term social cognitive training suggests that certain treatments enhance functioning across multiple domains of social cognition.CrossRef
17.
go back to reference Liberman RP, Wallace CJ, Blackwell G, et al.: Skills training versus psychosocial occupational therapy for persons with persistent schizophrenia. Am J Psychiatry 1998, 155:1087–1091.PubMed Liberman RP, Wallace CJ, Blackwell G, et al.: Skills training versus psychosocial occupational therapy for persons with persistent schizophrenia. Am J Psychiatry 1998, 155:1087–1091.PubMed
18.
go back to reference Benton MK, Schroeder HE: Social skills training with schizophrenics: a meta-analytic evaluation. J Consult Clin Psychol 1990, 58:741–747.CrossRefPubMed Benton MK, Schroeder HE: Social skills training with schizophrenics: a meta-analytic evaluation. J Consult Clin Psychol 1990, 58:741–747.CrossRefPubMed
19.
go back to reference Mueser KT, Penn DL: Meta-analysis examining the effects of social skills training on schizophrenia. Psychol Med 2002, 32:783–793. Mueser KT, Penn DL: Meta-analysis examining the effects of social skills training on schizophrenia. Psychol Med 2002, 32:783–793.
20.
go back to reference Evans JD, Bond GR, Meyer PS, et al.: Cognitive and clinical predictors of success in vocational rehabilitation in schizophrenia. Schizophr Res 2004, 70:331–342.CrossRefPubMed Evans JD, Bond GR, Meyer PS, et al.: Cognitive and clinical predictors of success in vocational rehabilitation in schizophrenia. Schizophr Res 2004, 70:331–342.CrossRefPubMed
21.
go back to reference Granholm E, McQuaid JR, McClure FS, et al.: A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. Am J Psychiatry 2005, 162:520–529.CrossRefPubMed Granholm E, McQuaid JR, McClure FS, et al.: A randomized, controlled trial of cognitive behavioral social skills training for middle-aged and older outpatients with chronic schizophrenia. Am J Psychiatry 2005, 162:520–529.CrossRefPubMed
22.
go back to reference Kurtz MM, Mueser KT: A meta-analysis of controlled research on social skills training for schizophrenia. J Consult Clin Psychol 2008, 76:491–504.CrossRefPubMed Kurtz MM, Mueser KT: A meta-analysis of controlled research on social skills training for schizophrenia. J Consult Clin Psychol 2008, 76:491–504.CrossRefPubMed
23.
go back to reference Wykes T, Katz R, Sturt E, Hemsley D: Abnormalities of response processing in a chronic psychiatric group: a possible predictor of failure in rehabilitation programs. Br J Psychiatry 1992, 160:244–252.CrossRefPubMed Wykes T, Katz R, Sturt E, Hemsley D: Abnormalities of response processing in a chronic psychiatric group: a possible predictor of failure in rehabilitation programs. Br J Psychiatry 1992, 160:244–252.CrossRefPubMed
24.
go back to reference •• Medalia A, Choi J: Cognitive remediation in schizophrenia. Neuropsychol Rev 2009, 19:353–364. This recent review examines differing approaches to cognitive remediation and provides important insight into the heterogeneity of responses to cognitive remediation. Factors such as varying instructional techniques, motivational factors, and ability level are discussed with regard to differential outcomes.CrossRefPubMed •• Medalia A, Choi J: Cognitive remediation in schizophrenia. Neuropsychol Rev 2009, 19:353–364. This recent review examines differing approaches to cognitive remediation and provides important insight into the heterogeneity of responses to cognitive remediation. Factors such as varying instructional techniques, motivational factors, and ability level are discussed with regard to differential outcomes.CrossRefPubMed
25.
go back to reference • Brekke JS, Nakagami E: The relevance of neurocognition and social cognition for outcome and recovery in schizophrenia. In Neurocognition and Social Cognition in Schizophrenia Patients. Basic Concepts and Treatment. Edited by Roder V, Medalia A. Basel, Switzerland: Karger; 2010:23–36. This chapter critically evaluates the most recent research on neurocognition and social cognition with an emphasis on their relevance to functional outcome in schizophrenia. Studies investigating how these domains may serve as predictors, mediators, and moderators of functioning are explored.CrossRef • Brekke JS, Nakagami E: The relevance of neurocognition and social cognition for outcome and recovery in schizophrenia. In Neurocognition and Social Cognition in Schizophrenia Patients. Basic Concepts and Treatment. Edited by Roder V, Medalia A. Basel, Switzerland: Karger; 2010:23–36. This chapter critically evaluates the most recent research on neurocognition and social cognition with an emphasis on their relevance to functional outcome in schizophrenia. Studies investigating how these domains may serve as predictors, mediators, and moderators of functioning are explored.CrossRef
26.
go back to reference Brekke JS, Kay DD, Lee KS, Green MF: Biosocial pathways to functional outcome in schizophrenia. Schizophr Res 2005, 80:213–225.CrossRefPubMed Brekke JS, Kay DD, Lee KS, Green MF: Biosocial pathways to functional outcome in schizophrenia. Schizophr Res 2005, 80:213–225.CrossRefPubMed
27.
go back to reference Wykes T, Huddy V: Cognitive remediation for schizophrenia: it is even more complicated. Curr Opin Psychiatry 2009, 22:161–167.CrossRefPubMed Wykes T, Huddy V: Cognitive remediation for schizophrenia: it is even more complicated. Curr Opin Psychiatry 2009, 22:161–167.CrossRefPubMed
28.
go back to reference Brekke JS, Hoe M, Long J, Green MF: How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia. Schizophr Bull 2007, 33:1247–1256.CrossRefPubMed Brekke JS, Hoe M, Long J, Green MF: How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia. Schizophr Bull 2007, 33:1247–1256.CrossRefPubMed
29.
go back to reference •• Brekke JS, Hoe M, Green MF: Neurocognitive change, functional change and service intensity during community-based psychosocial rehabilitation for schizophrenia. Psychol Med 2009, 39:1637–1647. This study examined the magnitude of neurocognitive change, whether neurocognitive change and functional change were interrelated, and how service intensity affected these domains for individuals with schizophrenia receiving psychosocial rehabilitation during a 1-year period. The authors found that neurocognitive improvers demonstrated functional improvement that was 350% greater than neurocognitive nonimprovers. In addition, there was a strong interaction between neurocognitive improvement, service intensity, and rate of functional improvement.CrossRefPubMed •• Brekke JS, Hoe M, Green MF: Neurocognitive change, functional change and service intensity during community-based psychosocial rehabilitation for schizophrenia. Psychol Med 2009, 39:1637–1647. This study examined the magnitude of neurocognitive change, whether neurocognitive change and functional change were interrelated, and how service intensity affected these domains for individuals with schizophrenia receiving psychosocial rehabilitation during a 1-year period. The authors found that neurocognitive improvers demonstrated functional improvement that was 350% greater than neurocognitive nonimprovers. In addition, there was a strong interaction between neurocognitive improvement, service intensity, and rate of functional improvement.CrossRefPubMed
30.
go back to reference Woodruff-Pak D: Neural Plasticity as a Substrate for Cognitive Adaptation in Adulthood and Aging. San Diego, CA: Academic Press; 1993. Woodruff-Pak D: Neural Plasticity as a Substrate for Cognitive Adaptation in Adulthood and Aging. San Diego, CA: Academic Press; 1993.
31.
go back to reference Velligan DI, Bow-Thomas CC: Two case studies of cognitive adaptation training for outpatients with schizophrenia. Psychiatr Serv 2000, 51:25–29.PubMed Velligan DI, Bow-Thomas CC: Two case studies of cognitive adaptation training for outpatients with schizophrenia. Psychiatr Serv 2000, 51:25–29.PubMed
32.
go back to reference McGurk SR, Twamley EW, Sitzer DI, et al.: A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007, 164:1791–1802.CrossRefPubMed McGurk SR, Twamley EW, Sitzer DI, et al.: A meta-analysis of cognitive remediation in schizophrenia. Am J Psychiatry 2007, 164:1791–1802.CrossRefPubMed
33.
go back to reference Lindenmayer JP, McGurk SR, Mueser KT, et al.: A randomized controlled trial of cognitive remediation among inpatients with persistent mental illness. Psychiatr Serv 2008, 59:241–247.CrossRefPubMed Lindenmayer JP, McGurk SR, Mueser KT, et al.: A randomized controlled trial of cognitive remediation among inpatients with persistent mental illness. Psychiatr Serv 2008, 59:241–247.CrossRefPubMed
34.
go back to reference • Szoke A, Trandafir A, Dupont ME, et al.: Longitudinal studies of cognition in schizophrenia: meta-analysis. Br J Psychiatry 2008, 192:257–266. This recent meta-analysis of longitudinal studies examining cognitive remediation in schizophrenia based on 2476 people demonstrated that participants improved in most cognitive domains, including memory, cognitive flexibility, and vigilance and attention.CrossRef • Szoke A, Trandafir A, Dupont ME, et al.: Longitudinal studies of cognition in schizophrenia: meta-analysis. Br J Psychiatry 2008, 192:257–266. This recent meta-analysis of longitudinal studies examining cognitive remediation in schizophrenia based on 2476 people demonstrated that participants improved in most cognitive domains, including memory, cognitive flexibility, and vigilance and attention.CrossRef
35.
go back to reference •• McGurk SR, Mueser KT, DeRosa TJ, Wolfe R: Work, recovery, and comorbidity in schizophrenia: a randomized controlled trial of cognitive remediation. Schizophr Bull 2009, 35:319–335. This study examined a hybrid treatment approach integrating cognitive remediation and vocational rehabilitation compared with vocational rehabilitation alone for people with schizophrenia. The hybrid approach showed superior work outcomes, and these gains demonstrated significant durability based on a 2-year follow-up period.CrossRefPubMed •• McGurk SR, Mueser KT, DeRosa TJ, Wolfe R: Work, recovery, and comorbidity in schizophrenia: a randomized controlled trial of cognitive remediation. Schizophr Bull 2009, 35:319–335. This study examined a hybrid treatment approach integrating cognitive remediation and vocational rehabilitation compared with vocational rehabilitation alone for people with schizophrenia. The hybrid approach showed superior work outcomes, and these gains demonstrated significant durability based on a 2-year follow-up period.CrossRefPubMed
36.
go back to reference •• Lecardeur L, Stip E, Giguere M, et al.: Effects of cognitive remediation therapies on psychotic symptoms and cognitive complaints in patients with schizophrenia and related disorders: a randomized study. Schizophr Res 2009, 111:153–158. In this study, two cognitive remediation therapy approaches were compared for individuals with schizophrenia, one targeting mental state attribution and the other targeting mental flexibility. Results suggested greater improvement in the mental flexibility group, a finding that helps shed light on the differential impact of cognitive remediation techniques.CrossRefPubMed •• Lecardeur L, Stip E, Giguere M, et al.: Effects of cognitive remediation therapies on psychotic symptoms and cognitive complaints in patients with schizophrenia and related disorders: a randomized study. Schizophr Res 2009, 111:153–158. In this study, two cognitive remediation therapy approaches were compared for individuals with schizophrenia, one targeting mental state attribution and the other targeting mental flexibility. Results suggested greater improvement in the mental flexibility group, a finding that helps shed light on the differential impact of cognitive remediation techniques.CrossRefPubMed
37.
go back to reference McGurk SR, Mueser KT: Response to cognitive rehabilitation in older versus younger persons with severe mental illness. Am J Psychiatr Rehabil 2008, 11:90–105.CrossRef McGurk SR, Mueser KT: Response to cognitive rehabilitation in older versus younger persons with severe mental illness. Am J Psychiatr Rehabil 2008, 11:90–105.CrossRef
38.
go back to reference Medalia A, Richardson R: What predicts a good response to cognitive remediation interventions? Schizophr Bull 2005, 31:942–953.CrossRefPubMed Medalia A, Richardson R: What predicts a good response to cognitive remediation interventions? Schizophr Bull 2005, 31:942–953.CrossRefPubMed
39.
go back to reference Silverstein SM, Spaulding WD, Menditto AA, et al.: Attention shaping: a reward-based learning method to enhance skills training outcomes in schizophrenia. Schizophr Bull 2009, 35:222–232.CrossRefPubMed Silverstein SM, Spaulding WD, Menditto AA, et al.: Attention shaping: a reward-based learning method to enhance skills training outcomes in schizophrenia. Schizophr Bull 2009, 35:222–232.CrossRefPubMed
40.
go back to reference Fisher M, Holland C, Merzenich MM, Vinogradov S: Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. Am J Psychiatry 2009, 166:805–811.CrossRefPubMed Fisher M, Holland C, Merzenich MM, Vinogradov S: Using neuroplasticity-based auditory training to improve verbal memory in schizophrenia. Am J Psychiatry 2009, 166:805–811.CrossRefPubMed
41.
go back to reference Cavallaro R, Anselmetti S, Poletti S, et al.: Computer-aided neurocognitive remediation as an enhancing strategy for schizophrenia rehabilitation. Psychiatry Res 2009, 169:191–196.CrossRefPubMed Cavallaro R, Anselmetti S, Poletti S, et al.: Computer-aided neurocognitive remediation as an enhancing strategy for schizophrenia rehabilitation. Psychiatry Res 2009, 169:191–196.CrossRefPubMed
42.
go back to reference Velligan DI, Diamond PM, Mintz J, et al.: The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia. Schizophr Bull 2008, 34:483–493.CrossRefPubMed Velligan DI, Diamond PM, Mintz J, et al.: The use of individually tailored environmental supports to improve medication adherence and outcomes in schizophrenia. Schizophr Bull 2008, 34:483–493.CrossRefPubMed
43.
go back to reference •• Penn DL, Sanna LJ, Roberts DL: Social cognition in schizophrenia: an overview. Schizophr Bull 2008, 34:408–411. This recent review synthesizes current research on the key domains of social cognition, including emotion perception, theory of mind, and attributional style. Findings from these studies are examined within the context of the relationship between social cognition and neurocognition, negative symptoms, and functional outcomes.CrossRefPubMed •• Penn DL, Sanna LJ, Roberts DL: Social cognition in schizophrenia: an overview. Schizophr Bull 2008, 34:408–411. This recent review synthesizes current research on the key domains of social cognition, including emotion perception, theory of mind, and attributional style. Findings from these studies are examined within the context of the relationship between social cognition and neurocognition, negative symptoms, and functional outcomes.CrossRefPubMed
44.
go back to reference Mayer JD, Salovey P, Caruso DR, Sitarenios G: Emotional intelligence as a standard of intelligence. Emotion 2001, 1:232–242.CrossRefPubMed Mayer JD, Salovey P, Caruso DR, Sitarenios G: Emotional intelligence as a standard of intelligence. Emotion 2001, 1:232–242.CrossRefPubMed
45.
go back to reference Kee KS, Horan WP, Wynn JK, et al.: An analysis of categorical perception of facial emotion in schizophrenia. Schizophr Res 2006, 87:228–237.CrossRefPubMed Kee KS, Horan WP, Wynn JK, et al.: An analysis of categorical perception of facial emotion in schizophrenia. Schizophr Res 2006, 87:228–237.CrossRefPubMed
46.
go back to reference Bora E, Yucel M, Pantelis C: Theory of mind impairment in schizophrenia: meta-analysis. Schizophr Res 2009, 109:1–9.CrossRefPubMed Bora E, Yucel M, Pantelis C: Theory of mind impairment in schizophrenia: meta-analysis. Schizophr Res 2009, 109:1–9.CrossRefPubMed
47.
go back to reference Couture SM, Penn DL, Roberts DL: The functional significance of social cognition in schizophrenia: a review. Schizophr Bull 2006, 32:S44–S63.CrossRefPubMed Couture SM, Penn DL, Roberts DL: The functional significance of social cognition in schizophrenia: a review. Schizophr Bull 2006, 32:S44–S63.CrossRefPubMed
48.
go back to reference Green MF, Olivier B, Crawley JN, et al.: Social cognition in schizophrenia: recommendations from the MATRICS new approaches conference. Schizophr Bull 2005, 31:882–887.CrossRefPubMed Green MF, Olivier B, Crawley JN, et al.: Social cognition in schizophrenia: recommendations from the MATRICS new approaches conference. Schizophr Bull 2005, 31:882–887.CrossRefPubMed
49.
go back to reference •• Wolwer W, Combs DR, Frommann N, Penn DL: Treatment approaches with a special focus on social cognition: overview and empirical results. In Neurocognition and Social Cognition in Schizophrenia Patients. Basic Concepts and Treatment. Edited by Roder V, Medalia A. Basel, Switzerland: Karger; 2010:61–78. This chapter summarizes the most current research on specialized treatment approaches targeting social cognition in schizophrenia. The authors evaluate narrow treatment approaches focusing on a single domain of social cognition, as well as broad-based strategies targeting multiple domains. •• Wolwer W, Combs DR, Frommann N, Penn DL: Treatment approaches with a special focus on social cognition: overview and empirical results. In Neurocognition and Social Cognition in Schizophrenia Patients. Basic Concepts and Treatment. Edited by Roder V, Medalia A. Basel, Switzerland: Karger; 2010:61–78. This chapter summarizes the most current research on specialized treatment approaches targeting social cognition in schizophrenia. The authors evaluate narrow treatment approaches focusing on a single domain of social cognition, as well as broad-based strategies targeting multiple domains.
50.
go back to reference Roncone R, Mazza M, Frangou I, et al.: Rehabilitation of theory of mind deficit in schizophrenia: a pilot study of metacognitive strategies in group treatment. Neuropsychol Rehabil 2004, 14:421–435.CrossRef Roncone R, Mazza M, Frangou I, et al.: Rehabilitation of theory of mind deficit in schizophrenia: a pilot study of metacognitive strategies in group treatment. Neuropsychol Rehabil 2004, 14:421–435.CrossRef
51.
go back to reference Moritz S, Woodward TS: Metacognitive training for schizophrenia patients (MCT): a pilot study on feasibility, treatment adherence, and subjective efficacy. Ger J Psychiatry 2007, 10:69–78. Moritz S, Woodward TS: Metacognitive training for schizophrenia patients (MCT): a pilot study on feasibility, treatment adherence, and subjective efficacy. Ger J Psychiatry 2007, 10:69–78.
52.
go back to reference Penn DL, Combs D: Modification of affect perception deficits in schizophrenia. Schizophr Res 2000, 46:217–229.CrossRefPubMed Penn DL, Combs D: Modification of affect perception deficits in schizophrenia. Schizophr Res 2000, 46:217–229.CrossRefPubMed
53.
go back to reference Addington J, Addington D: Facial affect recognition and information processing in schizophrenia and bipolar disorder. Schizophr Res 1998, 32:171–181.CrossRefPubMed Addington J, Addington D: Facial affect recognition and information processing in schizophrenia and bipolar disorder. Schizophr Res 1998, 32:171–181.CrossRefPubMed
54.
go back to reference • Combs DR, Tosheva A, Penn DL, et al.: Attentional-shaping as a means to improve emotion perception deficits in schizophrenia. Schizophr Res 2008, 105:68–77. This study represents a novel intervention using attentional-shaping procedures to draw attention to the center of the face in order to improve emotion perception for individuals with schizophrenia. The attentional-shaping condition showed significantly higher scores on the Face Emotion Identification Test than monetary reinforcement and repeated practice control groups.CrossRefPubMed • Combs DR, Tosheva A, Penn DL, et al.: Attentional-shaping as a means to improve emotion perception deficits in schizophrenia. Schizophr Res 2008, 105:68–77. This study represents a novel intervention using attentional-shaping procedures to draw attention to the center of the face in order to improve emotion perception for individuals with schizophrenia. The attentional-shaping condition showed significantly higher scores on the Face Emotion Identification Test than monetary reinforcement and repeated practice control groups.CrossRefPubMed
55.
go back to reference Russell TA, Chu E, Phillips ML: A pilot study to investigate the effectiveness of emotion recognition remediation in schizophrenia using the micro-expression training tool. Br J Clin Psychol 2006, 45:579–583.CrossRefPubMed Russell TA, Chu E, Phillips ML: A pilot study to investigate the effectiveness of emotion recognition remediation in schizophrenia using the micro-expression training tool. Br J Clin Psychol 2006, 45:579–583.CrossRefPubMed
56.
go back to reference Russell TA, Green MJ, Simpson I, Coltheart M: Remediation of facial emotion perception in schizophrenia: concomitant changes in visual attention. Schizophr Res 2008, 103:248–256.CrossRefPubMed Russell TA, Green MJ, Simpson I, Coltheart M: Remediation of facial emotion perception in schizophrenia: concomitant changes in visual attention. Schizophr Res 2008, 103:248–256.CrossRefPubMed
57.
go back to reference Wolwer W, Frommann N, Halfmann S, et al.: Remediation of impairments in facial affect recognition in schizophrenia: efficacy and specificity of a new training program. Schizophr Res 2005, 80:295–303.CrossRefPubMed Wolwer W, Frommann N, Halfmann S, et al.: Remediation of impairments in facial affect recognition in schizophrenia: efficacy and specificity of a new training program. Schizophr Res 2005, 80:295–303.CrossRefPubMed
58.
go back to reference Frommann N, Fleiter J, Peltzer M, et al.: Training of affect recognition (TAR) in schizophrenia: generalizability and durability of training effects. Schizophr Res 2008, 98:55.CrossRef Frommann N, Fleiter J, Peltzer M, et al.: Training of affect recognition (TAR) in schizophrenia: generalizability and durability of training effects. Schizophr Res 2008, 98:55.CrossRef
59.
go back to reference Penn DL, Roberts DL, Combs D, Sterne A: Best practices: the development of the social cognition and interaction program for schizophrenia spectrum disorders. Psychiatr Serv 2007, 58:449–451.CrossRefPubMed Penn DL, Roberts DL, Combs D, Sterne A: Best practices: the development of the social cognition and interaction program for schizophrenia spectrum disorders. Psychiatr Serv 2007, 58:449–451.CrossRefPubMed
60.
go back to reference Roberts DL, Penn DL: Social cognition and interaction training (SCIT) for outpatients with schizophrenia: a preliminary study. Psychiatry Res 2009, 166:141–147.CrossRefPubMed Roberts DL, Penn DL: Social cognition and interaction training (SCIT) for outpatients with schizophrenia: a preliminary study. Psychiatry Res 2009, 166:141–147.CrossRefPubMed
61.
go back to reference Combs DR, Adams SD, Penn DL, et al.: Social cognition and interaction training (SCIT) for patients with schizophrenia spectrum disorders: preliminary findings. Schizophr Res 2007, 91:112–116.CrossRefPubMed Combs DR, Adams SD, Penn DL, et al.: Social cognition and interaction training (SCIT) for patients with schizophrenia spectrum disorders: preliminary findings. Schizophr Res 2007, 91:112–116.CrossRefPubMed
62.
go back to reference • Combs DR, Penn DL, Tiegreen JA, et al.: Stability and generalization of social cognition and interaction training (SCIT) for schizophrenia: six-month follow-up results. Schizophr Res 2009, 112:196–197. This follow-up study examining SCIT for schizophrenia provides important information regarding the durability of social cognitive treatment approaches. Although the authors found that initial improvement had declined from post-test, SCIT participants demonstrated social cognitive performance on par with that of healthy controls at 6-month follow-up.CrossRefPubMed • Combs DR, Penn DL, Tiegreen JA, et al.: Stability and generalization of social cognition and interaction training (SCIT) for schizophrenia: six-month follow-up results. Schizophr Res 2009, 112:196–197. This follow-up study examining SCIT for schizophrenia provides important information regarding the durability of social cognitive treatment approaches. Although the authors found that initial improvement had declined from post-test, SCIT participants demonstrated social cognitive performance on par with that of healthy controls at 6-month follow-up.CrossRefPubMed
63.
go back to reference •• Roberts DL, Penn DL, Labate D: Transportability and feasibility of social cognition and interaction training (SCIT) in community settings. Behav Cogn Psychother 2010, 38:35–47. This study investigating SCIT in community settings provides evidence regarding the transportability of the approach in a real world setting. Results indicate significant improvements in social cognitive domains and favorable feedback from participants and clinicians with respect to feasibility in community-based agencies.CrossRefPubMed •• Roberts DL, Penn DL, Labate D: Transportability and feasibility of social cognition and interaction training (SCIT) in community settings. Behav Cogn Psychother 2010, 38:35–47. This study investigating SCIT in community settings provides evidence regarding the transportability of the approach in a real world setting. Results indicate significant improvements in social cognitive domains and favorable feedback from participants and clinicians with respect to feasibility in community-based agencies.CrossRefPubMed
64.
go back to reference Addis ME, Krasnow AD: A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. J Consult Clin Psychol 2000, 68:331–339.CrossRefPubMed Addis ME, Krasnow AD: A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. J Consult Clin Psychol 2000, 68:331–339.CrossRefPubMed
65.
go back to reference Turner-Brown LM, Perry TD, Dichter GS, et al.: Brief report: feasibility of social cognition and interaction training for adults with high functioning autism. J Autism Dev Disord 2008, 38:1777–1784.CrossRefPubMed Turner-Brown LM, Perry TD, Dichter GS, et al.: Brief report: feasibility of social cognition and interaction training for adults with high functioning autism. J Autism Dev Disord 2008, 38:1777–1784.CrossRefPubMed
66.
go back to reference • Horan WP, Kern RS, Shokat-Fadai K, et al.: Social cognitive skills training in schizophrenia: an initial efficacy study of stabilized outpatients. Schizophr Res 2009, 107:47–54. This randomized controlled trial of a social cognitive skills training group for individuals with schizophrenia living in the community highlights evidence for this approach based on a clinically stable population as opposed to an inpatient population. Participants showed significant improvement in facial affect perception and an 83% mean attendance rate.CrossRefPubMed • Horan WP, Kern RS, Shokat-Fadai K, et al.: Social cognitive skills training in schizophrenia: an initial efficacy study of stabilized outpatients. Schizophr Res 2009, 107:47–54. This randomized controlled trial of a social cognitive skills training group for individuals with schizophrenia living in the community highlights evidence for this approach based on a clinically stable population as opposed to an inpatient population. Participants showed significant improvement in facial affect perception and an 83% mean attendance rate.CrossRefPubMed
67.
go back to reference Velligan DI, Kern RS, Gold, JM: Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies. Schizophr Bull 2006, 32:474–485.CrossRefPubMed Velligan DI, Kern RS, Gold, JM: Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies. Schizophr Bull 2006, 32:474–485.CrossRefPubMed
68.
go back to reference • Barch DM, Yodkovik N, Sypher-Locke, et al.: Intrinsic motivation in schizophrenia: relationships to cognitive function, depression, anxiety, and personality. J Abnorm Psychol 2008, 117:776–787. This study provides important insight into the relationship between self-reports of IM and measures of cognitive functioning and negative symptoms in schizophrenia. Importantly, the authors found an incongruence between self-reports of IM and cognitive function.CrossRefPubMed • Barch DM, Yodkovik N, Sypher-Locke, et al.: Intrinsic motivation in schizophrenia: relationships to cognitive function, depression, anxiety, and personality. J Abnorm Psychol 2008, 117:776–787. This study provides important insight into the relationship between self-reports of IM and measures of cognitive functioning and negative symptoms in schizophrenia. Importantly, the authors found an incongruence between self-reports of IM and cognitive function.CrossRefPubMed
69.
go back to reference Silverstein SM: Bridging the gap between intrinsic and extrinsic motivation in the cognitive remediation of schizophrenia. Schizophr Bull 2010 Jan 11 (Epub ahead of print). Silverstein SM: Bridging the gap between intrinsic and extrinsic motivation in the cognitive remediation of schizophrenia. Schizophr Bull 2010 Jan 11 (Epub ahead of print).
70.
go back to reference •• Nakagami E, Xie B, Hoe M, Brekke JS: Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects. Schizophr Res 2008, 105:95–104. This investigation reveals the influence of neurocognition on psychosocial functioning through its relationship with IM. These findings highlight the need for interventions targeting IM.CrossRefPubMed •• Nakagami E, Xie B, Hoe M, Brekke JS: Intrinsic motivation, neurocognition and psychosocial functioning in schizophrenia: testing mediator and moderator effects. Schizophr Res 2008, 105:95–104. This investigation reveals the influence of neurocognition on psychosocial functioning through its relationship with IM. These findings highlight the need for interventions targeting IM.CrossRefPubMed
71.
go back to reference •• Gard DE, Fisher M, Garrett C, et al.: Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Schizophr Res 2009, 115:74–81. This study examines the role of motivation in relationship to social cognition, an area that few studies have investigated. Results suggest that motivation mediates the relationship between neurocognition, social cognition, and functional outcome.CrossRefPubMed •• Gard DE, Fisher M, Garrett C, et al.: Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Schizophr Res 2009, 115:74–81. This study examines the role of motivation in relationship to social cognition, an area that few studies have investigated. Results suggest that motivation mediates the relationship between neurocognition, social cognition, and functional outcome.CrossRefPubMed
72.
go back to reference • Yamada AM, Lee KK, Dinh TQ, et al.: Intrinsic motivation as a mediator of relationships between symptoms and functioning among individuals with schizophrenia spectrum disorders in a diverse urban community. J Nerv Ment Dis 2010, 198:28–34. This study found that IM mediates the relationship between clinical symptoms and functioning. Few studies have examined ethnic minority differences with regard to motivation, and results from this study indicate that motivation scores between ethnic minority individuals with schizophrenia and nonminority individuals differed significantly, although no moderation effect was found.CrossRefPubMed • Yamada AM, Lee KK, Dinh TQ, et al.: Intrinsic motivation as a mediator of relationships between symptoms and functioning among individuals with schizophrenia spectrum disorders in a diverse urban community. J Nerv Ment Dis 2010, 198:28–34. This study found that IM mediates the relationship between clinical symptoms and functioning. Few studies have examined ethnic minority differences with regard to motivation, and results from this study indicate that motivation scores between ethnic minority individuals with schizophrenia and nonminority individuals differed significantly, although no moderation effect was found.CrossRefPubMed
73.
go back to reference Vauth R, Corrigan PW, Clauss M, et al.: Cognitive strategies versus self-management skills as adjunct to vocational rehabilitation. Schizophr Bull 2005, 31:55–66.CrossRefPubMed Vauth R, Corrigan PW, Clauss M, et al.: Cognitive strategies versus self-management skills as adjunct to vocational rehabilitation. Schizophr Bull 2005, 31:55–66.CrossRefPubMed
74.
go back to reference Wexler BE, Bell MD: Cognitive remediation and vocational rehabilitation for schizophrenia. Schizophr Bull 2005, 31:931–941.CrossRefPubMed Wexler BE, Bell MD: Cognitive remediation and vocational rehabilitation for schizophrenia. Schizophr Bull 2005, 31:931–941.CrossRefPubMed
75.
go back to reference McGurk SR, Mueser KT, Pascaris A: Cognitive training and supported employment for persons with severe mental illness: one year results from a randomized controlled trial. Schizophr Bull 2005, 31:898–909.CrossRefPubMed McGurk SR, Mueser KT, Pascaris A: Cognitive training and supported employment for persons with severe mental illness: one year results from a randomized controlled trial. Schizophr Bull 2005, 31:898–909.CrossRefPubMed
76.
go back to reference •• Bell MD, Zito W, Grieg T, Wexler BE: Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophr Res 2008, 105:18–29. This randomized controlled trial of neurocognitive enhancement therapy is noteworthy in that the study addresses several methodologic concerns raised in previous studies by providing high-intensity treatment and measuring the durability of treatment effects based on a 100% follow-up after 2 years.CrossRefPubMed •• Bell MD, Zito W, Grieg T, Wexler BE: Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophr Res 2008, 105:18–29. This randomized controlled trial of neurocognitive enhancement therapy is noteworthy in that the study addresses several methodologic concerns raised in previous studies by providing high-intensity treatment and measuring the durability of treatment effects based on a 100% follow-up after 2 years.CrossRefPubMed
77.
go back to reference Tsang HW, Chan A, Wong A, Liberman RP: Vocational outcomes of an integrated supported employment program for individuals with persistent and severe mental illness. J Behav Ther Exp Psychiatry 2009, 40:292–305.CrossRefPubMed Tsang HW, Chan A, Wong A, Liberman RP: Vocational outcomes of an integrated supported employment program for individuals with persistent and severe mental illness. J Behav Ther Exp Psychiatry 2009, 40:292–305.CrossRefPubMed
78.
go back to reference •• Kern RS, Liberman RP, Becker DR, et al.: Errorless learning for training individuals with schizophrenia at a community mental health setting providing work experience. Schizophr Bull 2009, 35:807–815. This study represents a novel approach to integrating errorless learning with conventional job training in a community setting for individuals with schizophrenia. Results indicate modest support for the superiority of the hybrid approach as opposed to conventional job training in enhancing work performance.CrossRefPubMed •• Kern RS, Liberman RP, Becker DR, et al.: Errorless learning for training individuals with schizophrenia at a community mental health setting providing work experience. Schizophr Bull 2009, 35:807–815. This study represents a novel approach to integrating errorless learning with conventional job training in a community setting for individuals with schizophrenia. Results indicate modest support for the superiority of the hybrid approach as opposed to conventional job training in enhancing work performance.CrossRefPubMed
79.
go back to reference Major BS, Hinton MF, Flint A, et al.: Evidence of the effectiveness of a specialist vocational intervention following first episode psychosis: a naturalistic prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2010, 45:1–8.CrossRefPubMed Major BS, Hinton MF, Flint A, et al.: Evidence of the effectiveness of a specialist vocational intervention following first episode psychosis: a naturalistic prospective cohort study. Soc Psychiatry Psychiatr Epidemiol 2010, 45:1–8.CrossRefPubMed
80.
go back to reference Corbiere M, Lanctot N, Lecomte T, et al.: A pan-Canadian evaluation of supported employment programs dedicated to people with severe mental disorders. Community Ment Health J 2010, 46:44–55.CrossRefPubMed Corbiere M, Lanctot N, Lecomte T, et al.: A pan-Canadian evaluation of supported employment programs dedicated to people with severe mental disorders. Community Ment Health J 2010, 46:44–55.CrossRefPubMed
Metadata
Title
Vocational, Social, and Cognitive Rehabilitation for Individuals Diagnosed With Schizophrenia: A Review of Recent Research and Trends
Authors
Seth Kurzban
Lisa Davis
John S. Brekke
Publication date
01-08-2010
Publisher
Current Science Inc.
Published in
Current Psychiatry Reports / Issue 4/2010
Print ISSN: 1523-3812
Electronic ISSN: 1535-1645
DOI
https://doi.org/10.1007/s11920-010-0129-3

Other articles of this Issue 4/2010

Current Psychiatry Reports 4/2010 Go to the issue