Adding Cognitive Remediation to Employment Support Services: A Randomized Controlled Trial.

Area of Science:

• Mental Health Services Research
• Vocational Rehabilitation
• Cognitive Psychology

Background:

• Individual Placement and Support (IPS) is an effective employment strategy for individuals with mental illness, but nearly half do not secure work.
• Cognitive impairments can hinder employment success and limit rehabilitation benefits.
• This study investigates enhancing IPS with cognitive remediation for clients facing employment challenges.

Purpose of the Study:

• To evaluate the impact of adding cognitive remediation therapy (CRT) to IPS services.
• To determine if CRT improves employment outcomes for IPS clients who have not yet found work.
• To assess the effects of CRT on cognitive abilities and employment metrics.

Main Methods:

• A randomized controlled trial was conducted at 14 Canadian mental health centers.
• 97 clients receiving IPS for 3 months without employment were recruited.
• Participants were randomized to continue IPS alone or receive CRT integrated with IPS for 12 weeks.

Main Results:

• The addition of CRT to IPS significantly increased employment rates at 3-month and 9-month follow-ups.
• CRT participants worked more hours and earned higher wages over the 9-month period.
• Both groups showed cognitive improvements, but CRT specifically enhanced employment.

Conclusions:

• Cognitive remediation therapy, particularly with coping and compensatory strategies, enhances employment outcomes.
• CRT is beneficial for individuals with mental illness who do not immediately benefit from IPS alone.
• Integrating CRT into vocational rehabilitation services can improve competitive employment rates.