Cognitive Training and Supported Employment for SMI

SMI 的认知培训和支持性就业

• 批准号: 7228611
• 负责人: SUSAN R. MCGURK
• 金额: $ 30.45万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-05-02 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7228611
• 关键词: Attention; Client; Cognition; Cognitive; Cognitive remediation; Collaborations; Communities; Computers; Condition; Consultations; Controlled Study; Coping Skills; Data; Development; Educational Intervention; Educational process of instructing; Effectiveness; Employment; Enrollment; Evidence based practice; Exercise; Fire - disasters; Goals; Hour; Impaired cognition; Intervention; Learning; Life; Living Wills; Memory; Neurobehavioral Manifestations; Occupations; Outcome; Participant; Performance at work; Pilot Projects; Program Effectiveness; Quality of life; Quality-of-Life Assessment; Randomized; Randomized Controlled Trials; Recording of previous events; Rehabilitation therapy; Research; Research Personnel; Role; Services; Specialist; Speed; Supported Employment; Symptoms; Testing; Thinking; Training; Training Programs; Training Support; Unemployment; Vocational rehabilitation; Wages; Work; Workplace; cognitive function; coping; day; design; executive function; follow-up; improved; inner city; member; programs; severe mental illness; skills; tool

DESCRIPTION (provided by applicant): Project Summary: Supported employment (SE) is firmly established as an evidence-based practice for clients with severe mental illness (SMI). However, a significant proportion of clients in SE programs either fail to work or have great difficulty maintaining their jobs, and new strategies are urgently needed to improve the effectiveness of these programs. Cognitive impairment is a major contributing factor to these poor work outcomes and an important target for rehabilitation efforts. The proposed research will evaluate the effectiveness of a cognitive training program for improving the outcomes of clients enrolled in SE programs. The intervention (The Thinking Skills for Work Program) is a cognitive training program that is fully integrated into SE services and combines computer cognitive exercises with cognitive assessment, job planning, and job support consultation provided by a cognitive specialist. The program has been manualized and pilot tested in a small (n=44) randomized controlled trial in 2 inner-city SE programs, and found to improve cognitive functioning and work compared to SE only. This randomized controlled trial will evaluate the effectiveness of The Thinking Skills for Work Program by comparing it to enhanced SE services in clients with SMI who are participants in a high fidelity supported employment program, but who have difficulty getting or keeping jobs. A total of 80 clients will be randomized to either cognitive training and supported employment (CT+SE) or enhanced supported employment (E-SE), with cognitive, symptom, and quality of life assessments performed at baseline, 3 months (post-computer cognitive training), 12 months, and 24 months, and employment data gathered over the full 2-year period. For the E-SE condition, SE services will be enhanced by training employment specialists how to recognize cognitive problems related to work performance, and how to teach clients coping strategies for managing these problems. Primary analyses will focus on testing the hypotheses that The Thinking Skills for Work program leads to better cognitive functioning and better competitive work outcomes over the 2-year follow-up period compared to the E-SE program. If the results of this study support the added effects of the cognitive training program to SE outcomes, the field will have a valuable hew tool for helping clients with SMI and cognitive impairment achieve their vocational goals, and become more integrated members of their communities. Relevance: This controlled study will evaluate the effects of a promising cognitive training program for clients with severe mental illness who have difficulty benefiting from customary supported employment. If found to be effective, this cognitive training program will enable many people with severe mental illness to work and live more productive lives.

描述（由申请人提供）： 项目摘要：支持性就业 (SE) 已被牢固确立为针对患有严重精神疾病 (SMI) 的客户的循证实践。然而，SE项目中很大一部分客户要么无法工作，要么很难维持工作，迫切需要新的策略来提高这些项目的有效性。认知障碍是导致这些不良工作成果的一个主要因素，也是康复工作的一个重要目标。拟议的研究将评估认知培训计划对于改善参加 SE 计划的客户的结果的有效性。该干预措施（工作思维技能计划）是一项认知培训计划，完全融入SE服务中，并将计算机认知练习与认知专家提供的认知评估、工作规划和工作支持咨询相结合。该计划已在 2 个市中心 SE 计划的小型 (n=44) 随机对照试验中进行了手动化和试点测试，结果发现与仅 SE 相比，该计划可以改善认知功能和工作。这项随机对照试验将通过将工作思维技能计划与 SMI 客户的强化 SE 服务进行比较来评估工作思维技能计划的有效性，这些客户是高保真支持就业计划的参与者，但在获得或保住工作方面存在困难。总共 80 名客户将被随机分配到认知培训和支持性就业 (CT+SE) 或增强支持性就业 (E-SE) 组，并在基线、3 个月（计算机后）进行认知、症状和生活质量评估。认知训练）、12 个月和 24 个月，以及整个 2 年期间收集的就业数据。对于 E-SE 条件，SE 服务将通过培训就业专家如何识别与工作绩效相关的认知问题以及如何教授客户应对这些问题的策略来增强 SE 服务。主要分析将侧重于测试以下假设：与 E-SE 计划相比，工作思维技能计划在 2 年的随访期内可带来更好的认知功能和更好的竞争性工作成果。如果这项研究的结果支持认知培训计划对 SE 结果的附加影响，那么该领域将拥有一个有价值的工具，可以帮助患有 SMI 和认知障碍的客户实现他们的职业目标，并成为社区中更加融合的成员。 相关性：这项对照研究将评估一项有前途的认知培训计划对患有严重精神疾病且难以从常规支持性就业中受益的客户的影响。如果发现有效，这项认知训练计划将使许多患有严重精神疾病的人能够工作和过上更富有成效的生活。