Extensions of errorless learning for social problem-solving deficits in schizophrenia

Am J Psychiatry. 2005 Mar;162(3):513-9. doi: 10.1176/appi.ajp.162.3.513.

Abstract

Objective: There is a clear need to develop psychosocial rehabilitation methods that compensate for neurocognitive deficits common to persons with severe and persistent mental illness. Errorless learning, a compensatory training intervention, has been successful in teaching entry-level job tasks. However, errorless learning's applicability to broader, more complex functions is unknown. The present study tested the extension of errorless learning for deficits in social problem-solving skills in patients with schizophrenia.

Method: Sixty clinically stable outpatients with schizophrenia or schizoaffective disorder were stratified by gender and level of memory impairment before being randomly assigned to one of two training programs: errorless learning or symptom management. Groups were matched for training time, format and structure of training, and types of teaching aids used. Social problem-solving ability, measured by the Assessment of Interpersonal Problem-Solving Skills, was assessed at baseline, within 2 days of training completion, and after 3 months. Dependent measures were the scores for the receiving, processing, and sending skills areas from the Assessment of Interpersonal Problem-Solving Skills.

Results: A repeated-measures analysis of covariance was conducted for each dependent measure with baseline Assessment of Interpersonal Problem-Solving Skills score entered as a covariate. For all three skills, there was a significant training group effect favoring errorless learning. Durability of errorless learning training effects extended to the 3-month follow-up assessment for processing and sending skills but not receiving skills.

Conclusions: Results support the extension of errorless learning to complex functions such as social problem-solving skills in the rehabilitation of persons with schizophrenia.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Ambulatory Care
  • Behavior Therapy / methods
  • Cognition Disorders / psychology
  • Cognition Disorders / rehabilitation*
  • Cognition Disorders / therapy
  • Female
  • Humans
  • Interpersonal Relations
  • Learning*
  • Male
  • Memory Disorders / psychology
  • Memory Disorders / rehabilitation
  • Memory Disorders / therapy
  • Overlearning
  • Practice, Psychological
  • Problem Solving*
  • Reinforcement, Social
  • Schizophrenia / rehabilitation*
  • Schizophrenia / therapy
  • Schizophrenic Psychology*
  • Social Adjustment*
  • Teaching / methods*
  • Treatment Outcome