Adapting cognitive remediation to a group home: A brief report

Objective: This pilot project was designed to develop procedures for and test the feasibility of implementing Cognitive Enhancement Therapy (CET) in a group home environment, with a goal of maximizing treatment efficacy by augmenting social engagement in group CET sessions with ongoing social interaction.

Methods: Six participants who met criteria including chronic schizophrenia were recruited in a group home with 30 residents. After two months of CET, pre-and posttest measures, including cognitive tests, were administered and qualitative interviews were conducted periodically. Interaction was observed in the house and staff members were interviewed in a focus group.

Results: Five of the initial six participants completed the intervention-which continued for a total of 45 weeks-engaging in weekly group CET sessions and computer exercises outside of the formal sessions. All participants liked the computer exercises, and all but one participated in and reported enjoying the group exercises. Observations and staff comments indicated increased social interaction and sustained impact for some residents. Some aspects of cognitive functioning improved for some participants during the initial two months.

Conclusions: CET now needs to be tested more formally to determine if it can be delivered successfully in other group homes with a manualized procedure. The idea should be tested that feedback effects due to the sustained social contact may enhance the effectiveness of CET in group homes and lead to larger, sustained gains in community functioning. Clinicians who provide cognitive interventions should focus attention on the social context in which treatment is delivered and consider providing treatment to patient groups whose daily, ongoing social interaction can enhance its effects.