McGurk Susan R, Mueser Kim T, Feldman Karin, Wolfe Rosemarie, Pascaris Alysia
New Hampshire-Dartmouth Psychiatric Research Center, Concord, NH 03301, USA.
Am J Psychiatry. 2007 Mar;164(3):437-41. doi: 10.1176/ajp.2007.164.3.437.
To address cognitive impairments that limit the effectiveness of supported employment services for patients with schizophrenia, a cognitive training program, the Thinking Skills for Work Program, was developed and integrated into supported employment services.
Patients with severe mental illness (N=44) and prior histories of job failures who were enrolled in supported employment programs at two sites in New York City were randomly assigned to receive either supported employment alone or supported employment with cognitive training. Measures at baseline and 3 months included a brief cognitive and symptom assessment. Work outcomes were tracked for 2-3 years.
Patients in the supported employment with cognitive training program demonstrated significantly greater improvements at 3 months in cognitive functioning, depression, and autistic preoccupation. Over 2-3 years, patients in the supported employment with cognitive training program were more likely to work, held more jobs, worked more weeks, worked more hours, and earned more wages than patients in the program offering supported employment alone.
The findings support the feasibility of integrating cognitive rehabilitation into supported employment programs and suggest that more research is warranted to evaluate the effects of the Thinking Skills for Work Program.
为解决限制精神分裂症患者支持性就业服务有效性的认知障碍问题，开发了一种认知训练项目——工作思维技能项目，并将其纳入支持性就业服务中。
在纽约市两个地点参加支持性就业项目、有严重精神疾病史（N = 44）且有工作失败经历的患者被随机分配，分别接受单纯支持性就业服务或支持性就业与认知训练相结合的服务。基线和3个月时的测量包括简短的认知和症状评估。对工作成果进行了2至3年的跟踪。
接受支持性就业与认知训练项目的患者在3个月时，在认知功能、抑郁和孤独症式专注方面有显著更大的改善。在2至3年的时间里，与仅提供支持性就业服务项目的患者相比，接受支持性就业与认知训练项目的患者更有可能工作、拥有更多工作、工作周数更多、工作小时数更多且收入更高。
研究结果支持将认知康复纳入支持性就业项目的可行性，并表明有必要进行更多研究以评估工作思维技能项目的效果。
