Article Details

Research Database: Article Details

Citation:  McGurk, S. R., Mueser, K. T., & Pascaris, A. (2005). Cognitive training and supported employment for persons with severe mental illness: One-year results from a randomized controlled trial. Schizophrenia Bulletin, 31 (4), 898-909.
Title:  Cognitive training and supported employment for persons with severe mental illness: One-year results from a randomized controlled trial
Authors:  McGurk, S. R., Mueser, K. T., & Pascaris, A.
Year:  2005
Journal/Publication:  Schizophrenia Bulletin
Publisher:  Oxford University Press
Full text:   
Peer-reviewed?  Yes
NIDILRR-funded?  Not reported
Research design:  Randomized controlled trial

Structured abstract:

Background:  Individuals with severe mental illness have poor unemployment rates. Past research indicates supported employment can help improve employment rates among this group. However, not all person with severe mental illness have benefited from that model. For example, poor job tenure rates have been reported. Therefore, it is important to try to improve the effectiveness of these programs. One possible way to enhance outcomes may relate to improving cognitive functioning through an intervention such as cognitive training.
Purpose:  The purpose of this study was to measure the impact of cognitive rehabilitation on employment outcomes among individuals with severe mental illness who had not been successfully employed and were receiving supported employment services.
Setting:  The study took place at two mental health centers that provided a wide range of services including supported employment.
Study sample:  Participants included 44 individuals with severe mental illness who were receiving services from 2 mental health centers in New York. The majority were males (62%), from a minority like African American (59%), followed by Hispanic (24%) and had a diagnosis of Schizophrenia. The mean age of participants was 31 years and most had relatively low levels of education. Participants were assigned to either the cognitive training and supported employment program or supported employment.
Intervention:  The intervention was cognitive training titled Thinking Skills for Work and supported employment services.
Control or comparison condition:  The control was supported employment services without cognitive training.
Data collection and analysis:  Comprehensive employment data were collected the first year. Cognitive and psychological assessments were administered at baseline and three months later. Diagnostic and background information were retrieved from the participants charts, interviews, and staff reports. Employment outcomes were measured through contact with the participants and staff. Seven different tests were used to measure cognitive functions (ie. attention and concentration,psychomotor speed, information processing speed, verbal learning and memory, executive functioning and overall cognitive functioning) at baseline and 3 month follow up. Psychiatric symptoms were measured with interviews using the Positive and Negative Syndrome Scale. Efforts were made to get follow up employment data for the one year following randomization. Intent to treat analyses of the employment outcomes were conducted on the entire randomized sample that had some follow up data (n=44). The statistical analysis included: x2, t test and analyses of covariance. Due to skewed data Mann Whitney U tests were also used.
Findings:  The rate of retention of the cognitive training program was high. The program was successfully implemented at two sites that predominately served inner city minorities. Participant who received cognitive training showed improvements in several areas over the first 3 months of the study as well as a better overall cognitive functioning score as compared to those who received only supported employment services. They also had higher rates of employment. Notably, this group showed improvements on the PANSS depression scale.
Conclusions:  The Thinking Skills for Work program may help individuals with severe mental illness with employment. This program was successfully implemented in a challenging inner city setting. More research is needed.

Disabilities served:  Schizophrenia
Populations served:  Gender: Female and Male
Race: Black / African American
Race: White / Caucasian
Ethnicity: Hispanic or Latino
Interventions:  Other
Outcomes:  Wages