Cognitive Training to Enhance VA Work Program Outcomes
| Status: | Completed |
|---|---|
| Conditions: | Depression, Schizophrenia, Psychiatric, Bipolar Disorder |
| Therapuetic Areas: | Psychiatry / Psychology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 8/22/2018 |
| Start Date: | May 2008 |
| End Date: | December 2016 |
The purpose of this study is to determine whether augmenting work services with cognitive
remediation can improve vocational outcomes for psychiatrically disabled participants in VA
work services.
remediation can improve vocational outcomes for psychiatrically disabled participants in VA
work services.
Background: Our previous RR&D funded study demonstrated significantly better vocational
outcomes for people with schizophrenia when cognitive training supplemented their
participation in Incentive Therapy. We have found in a subsequent NIMH funded study involving
cognitive training and supported employment that competitive employment outcomes were better
for those who received cognitive training. Moreover, we found that patients with the poorest
community function at intake were very unlikely to obtain competitive employment unless they
received the cognitive training. The current study will test the effectiveness of cognitive
training by extending it to a broader range of VA patients with psychotic disorders
participating in all types of VA work services currently available, including Incentive
Therapy, Compensated Work Therapy, and Supported Employment. We plan to offer it to any
patient with a psychotic disorder who is unlikely to obtain competitive employment without
additional services. We will also compare two types of cognitive training to determine
whether cognitive game software works as well narrowly focused cognitive exercises.
Design and Method: This is a randomized clinical trial in which 80 VA patients referred for
VA work services and who meet criteria for psychotic disorder and impaired community function
will be randomized to one of two types of cognitive training. There will be two conditions
with approximately 40 subjects per condition. Intake procedures will include psychosocial,
neuropsychological, and psychiatric assessments. These assessments will be repeated at
6-months and 12 month follow-up. Cognitive training will consist of computer-based cognitive
exercises of attention, memory and problem-solving and a weekly group that focuses on
improving work behaviors. One of the computer-based systems employs engaging cognitive game
software and the other uses specially designed exercises that narrowly focus on discrete
cognitive processes. Work services will be provided as usual to both conditions. Primary
endpoints are measures of productive activity including obtaining competitive employment,
total hours worked, and money earned. Secondary endpoints include neuropsychological, quality
of life and health status changes. The study will be for three years.
outcomes for people with schizophrenia when cognitive training supplemented their
participation in Incentive Therapy. We have found in a subsequent NIMH funded study involving
cognitive training and supported employment that competitive employment outcomes were better
for those who received cognitive training. Moreover, we found that patients with the poorest
community function at intake were very unlikely to obtain competitive employment unless they
received the cognitive training. The current study will test the effectiveness of cognitive
training by extending it to a broader range of VA patients with psychotic disorders
participating in all types of VA work services currently available, including Incentive
Therapy, Compensated Work Therapy, and Supported Employment. We plan to offer it to any
patient with a psychotic disorder who is unlikely to obtain competitive employment without
additional services. We will also compare two types of cognitive training to determine
whether cognitive game software works as well narrowly focused cognitive exercises.
Design and Method: This is a randomized clinical trial in which 80 VA patients referred for
VA work services and who meet criteria for psychotic disorder and impaired community function
will be randomized to one of two types of cognitive training. There will be two conditions
with approximately 40 subjects per condition. Intake procedures will include psychosocial,
neuropsychological, and psychiatric assessments. These assessments will be repeated at
6-months and 12 month follow-up. Cognitive training will consist of computer-based cognitive
exercises of attention, memory and problem-solving and a weekly group that focuses on
improving work behaviors. One of the computer-based systems employs engaging cognitive game
software and the other uses specially designed exercises that narrowly focus on discrete
cognitive processes. Work services will be provided as usual to both conditions. Primary
endpoints are measures of productive activity including obtaining competitive employment,
total hours worked, and money earned. Secondary endpoints include neuropsychological, quality
of life and health status changes. The study will be for three years.
Inclusion Criteria:
- Participant in VA work services
- Chronic and disabling psychiatric illness
Exclusion Criteria:
- Neurological Disease that may affect cognition
- Primary substance abuse
- Developmental Disability
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VA Connecticut Healthcare System VA Connecticut encompasses an inpatient facility and Ambulatory Care Center in...
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