Cognitive Training and Supported Employment for SMI

SMI 的认知培训和支持性就业

• 批准号: 7087358
• 负责人: SUSAN R. MCGURK
• 金额: $ 33.71万
• 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/7087358
• 关键词: attention; behavioral /social science research tag; clinical research; cognition disorders; computer assisted instruction; coping; counseling; employment /unemployment; executive function; health services research tag; human subject; human therapy evaluation; interview; job performance; job satisfaction; learning; longitudinal human study; medical rehabilitation related tag; memory; mental disorders; outcomes research; psychological tests; psychomotor reaction time; thinking; training; vocational rehabilitation

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：支持的就业（SE）是针对患有严重精神疾病（SMI）的客户的循证实践确定的。但是，SE计划中的很大一部分客户要么无法工作，要么在保持工作方面有很大的困难，并且迫切需要新的策略来提高这些计划的有效性。认知障碍是导致这些不良锻炼成果的主要因素，也是康复工作的重要目标。拟议的研究将评估认知培训计划的有效性，以改善参与SE计划的客户的结果。干预措施（工作计划的思维技巧）是一个认知培训计划，该计划已完全集成到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，工作计划和工作支持咨询相结合。该程序已在2个城市内部SE计划中的小（n = 44）随机对照试验中进行了手动测试，并发现仅与SE相比，可以改善认知功能和工作。这项随机对照试验将通过将其与SMI的增强的SE服务进行比较，他们是高保真支持就业计划，但很难找到工作或保持工作的SMI，可以评估工作能力的有效性。共有80名客户将被随机分配给认知培训和支持的就业（CT+SE）或增强的支持就业（E-SE），以及在基线时进行认知，症状和生活质量评估，3个月（后计算机认知培训），12个月和24个月，以及在整个2年期间收集的就业数据。对于E-SE条件，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客户应对管理这些问题的策略，可以增强SE服务。主要分析将着重于测试工作计划的思维能力可以提高认知功能和更好的竞争性工作成果的假设，而与E-SE计划相比，在两年的随访期内。如果这项研究的结果支持认知培训计划对成果的额外影响，那么该领域将拥有一个有价值的HEW工具来帮助SMI和认知障碍的客户实现其职业目标，并成为其社区中更加融合的成员。 相关性：这项对照研究将评估有前途的认知培训计划对严重精神疾病的患者的影响，这些患者难以受益于习惯支持的就业。如果发现有效，这项认知培训计划将使许多患有严重精神疾病的人能够工作并过上更有生产力的生活。