Building Employment Skills Through Therapy for Veterans (BESTVet)

VA Office of Research and Development

Status

Completed

Conditions

Schizophrenia

Schizoaffective Disorder

Treatments

Behavioral: Computerized cognitive remediation (CCR)

Other: Usual Care

Behavioral: integrated Cognitive Behavioral Therapy

Study type

Interventional

Funder types

Other U.S. Federal agency

Identifiers

NCT01992913

D1157-R

Details and patient eligibility

About

Schizophrenia/Schizoaffective Disorder is associated with serious problems with cognitive skills, social skills, and functional skills (like employment). There is a new form of cognitive behavioral therapy called integrated cognitive behavioral therapy (iCBT) that specifically addresses the cognitive, social, and functional deficits of schizophrenia/schizoaffective disorder. This study compared iCBT to the usual care (UC) that Veteran's receive. The investigators compared iCBT to UC in subjects with schizophrenia/schizoaffective disorder who are enrolled in a Supported Employment (SE) program, and evaluate whether iCBT is more helpful in improving job attainment, and other areas of functioning, both right after treatment, and 6 months after the end of treatment.

Full description

The objective of the current study was to evaluate whether integrated cognitive behavior therapy (iCBT) can improve engagement and success in an existing Supported Employment (SE) program among the most functionally disabled patients with schizophrenia/schizoaffective disorder. The iCBT condition also included computerized cognitive remediation. The primary specific aim was to determine whether iCBT will significantly improve work outcomes at post-treatment to a greater extent than Usual Care (UC) in low functioning patients with schizophrenia/schizoaffective disorder who join the SE program. The secondary aims were to evaluate the whether iCBT will significantly improve work outcomes at 6 month follow-up relative to UC, and whether iCBT will improve functional outcomes post-treatment and at follow-up relative to UC in subjects who join the SE program.

Enrollment

67 patients

Sex

All

Ages

18 to 65 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Diagnosis of DSM-IV schizophrenia or schizoaffective disorder (SCID)
Severe/extreme functional disability [World Health Organization Disability Assessment Scale (WHODAS) score > 50]
Clinical stability (as per primary mental health provider)
Receiving treatment at the Veterans Administration
Minimal engagement in psychiatric rehabilitation services (just psychiatrist and therapist/case management in the last 6 months)
Eligible for and willing to be enrolled in Supported Employment program
Age 18 to 65
Proficient in English
Able to give informed consent

Exclusion criteria

Neurologic disease or damage that would make the diagnosis of schizophrenia questionable
Current opioid or stimulant dependence (SCID)
Not appropriate due to safety concerns (based on risk assessment)