Cognitive Training and Enhanced Supported Employment in Schizophrenia

Schizophrenia is a chronic, severe, and disabling brain disorder that affects 2.4 million
people in the United States. Individuals with schizophrenia may have difficulties with
cognitive functioning, including problems with attention, memory, and organizational thought
processes. These factors can lead to decreased productivity and poor work performance, which
may make holding a job difficult. Research has shown that certain types of psychological
therapies, such as cognitive behavioral therapy, are useful in reducing the severity of
schizophrenic symptoms. The purpose of this study is to determine whether a computer-based
cognitive enhancement training program, in combination with a work therapy program, will
enhance workplace performance, productivity, and quality of life in individuals with
schizophrenia.

This study will enroll individuals with schizophrenia or schizoaffective disorder.
Participants will undergo a cognitive assessment at baseline. They will then be randomly
assigned to either a 12-month cognitive enhancement training program plus a 12-month work
therapy program or a 12-month work therapy program alone. Participants in the cognitive
enhancement training program will receive feedback on their cognitive strengths and
weaknesses based on the outcomes of the baseline assessment. The training component will be
comprised of 150 computer-based exercises that focus on improving memory, attention, and
organizational skills. Participants will attend two weekly meetings: one will focus on
providing feedback regarding goal-setting and problem-solving, and the other will focus on
improving verbal skills and social information processing. Individuals taking part only in
the work therapy program will attend two non-cognitive discussion groups per week. All
participants will work up to 20 hours a week in an approved work environment, and will have
access to appropriate support services. Following the end of the program, participants will
have the option of working an additional 12 months. Schizophrenia symptoms, quality of life,
and neuropsychological and rehabilitation effects will be assessed at the end of Years 1 and
2.

Inclusion Criteria:

- Diagnosis of schizophrenia or schizoaffective disorder

Exclusion Criteria:

- Hospitalized in the 30 days prior to study entry

- Homeless in the 30 days prior to study entry

- Changed medications in the 30 days prior to study entry

- Substance abuse in the 30 days prior to study entry

- History of head trauma