A Study of the Effectiveness of Cognitive Adaptation Training in Early Intervention for Psychosis

Center for Addiction and Mental Health (CAMH)

Status: Completed

Conditions: Psychosis

Treatments: Behavioral: Action Based Cognitive Remediation; Behavioral: Cognitive Adaptation Training

Study type: Interventional

Funder types: Other

Identifiers

NCT02430935

03/24/2015

Details and patient eligibility

About

The proposed study will involve a randomized trial of Cognitive Adaptation Training (CAT) for early intervention as compared against an active control in which Action Based Cognitive Remediation (ABCR) will be applied.

Full description

The proposed project will expand knowledge of the role of compensatory and restorative cognitive interventions for early intervention population individuals with schizophrenia. The investigators will conduct a two arm randomized trial comparing the impacts of CAT and Action Based Cognitive Remediation (ABCR) for individuals with schizophrenia who are under the age of 30. The model would mirror the investigators' preliminary work at CAMH (Kidd et al., 2014) in which there will be 4 months of specialist-delivered treatment followed by 5 months of maintenance by case managers with pre, 4 month, and 9 month evaluations conducted. This study will be among the most rigorous examinations of such interventions to date, would be among the first to examine integrative approaches, and would make a substantial contribution to the early intervention literature.

The questions for the purposes of this project are:

1. Is CAT effective among individuals with schizophrenia under the age of 30?

   and

2. Does integrating cognitive remediation with CAT enhance outcomes as compared with CAT alone?

Enrollment: 67 patients

Sex: All

Ages: 16 to 29 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Participants must be CAMH clients, have an assigned caseworker, be between the ages of 16-34 and have a psychosis such as schizophrenia or schizoaffective disorder.

Exclusion criteria

• not currently experiencing high level of paranoia.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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67 participants in 2 patient groups

Cognitive Adaptation Training

Experimental group

Description:

Cognitive Adaptation Training (CAT) is a standardized approach to the use of environmental supports for improving multiple domains of adaptive functioning including adherence to medication, grooming, and activities of daily living in patients with schizophrenia.

Treatment:

Behavioral: Cognitive Adaptation Training

Action Based Cognitive Remediation

Active Comparator group

Description:

ABCR is applied in once weekly 2 hour sessions in small groups (6-8 per group). In these group sessions, simulated bridging activities are done immediately following computerized cognitive activation to increase the chance that participants retain the strategies just developed in a real life environment.

Treatment:

Behavioral: Action Based Cognitive Remediation