How Effective is Cognitive Rehabilitation in Schizophrenia?

Cognitive rehabilitation is becoming an increasingly popular intervention in treatment programs for people with schizophrenia. Despite this increased acceptance, however, the actual evidence concerning its effectiveness is not impressive. Considering the evidence of cognitive recovery in patients treated with medication or other evidence-based psychosocial interventions who do not receive cognitive rehabilitation, It is not clear whether cognitive rehabilitation is worth the expense in time and resources. An article in a recent issue of Schizophrenia Bulletin provides an overview of recent research examining the value of cognitive rehabilitation strategies in treatment schizophrenics.  The authors argue that the slow progress in the field of cognitive rehabilitation of schizophrenia is related to failure to address several critical issues: (1) the importance of manipulating stimulus and context structure in rehabilitative interventions; (2) the need to base a cognitive rehabilitation of schizophrenia on cognitive neuroscience as opposed to neuropsychology; (3) the importance of systematically addressing motivation, self-esteem, and affective factors when designing cognition-enhancing interventions; (4) the need to move beyond one-size-fits-all interventions and develop individualized treatments; and (5) the need to address abnormalities in the experience of the self when designing interventions to optimize cognitive and behavioral performance.  Cognitive rehabilitation works best as part of a structured approach that combines different strategies for improving cognitive functioning including use of real-time feedback methods to reinforce gains.  The potential value of cognitive rehabilitation in helping treatment-resistant schizophrenics is only beginning to be understood.

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Comments

[Bart]

The entire history of mental health is filled with many examples of failed treatments. It is unfortunate.