Cognitive enhancement therapy: a therapeutic treatment strategy for first-episode schizophrenia patients

Cognitive enhancement therapy (CET) for first-episode schizophrenia combines supportive therapy with social skills and cognitive remediation training. It includes exercises aimed at ameliorating cognitive and negative symptoms in a purposefully motivational format. In this treatment model, the clinician takes an active role as coach, teacher, and therapist in order to engage patients in skills-enhancing work matched to levels of illness and abilities. The therapeutic alliance allows for a safe environment to utilize principles of errorless learning and positive reinforcement. Although this strategy is best implemented in groups, it can be adapted to the individual mode of treatment. Skills-building exercises are described in sufficient detail to be useful to clinicians working with patients in the first years of schizophrenia.