Cognitive Remediation and Employment Services

October 10, 2002

The New York Work Exchange has initiated a study to evaluate the effectiveness of combining cognitive remediation and supported employment services — for consumers of mental health services.

There's a growing body of literature supporting the view that individuals with psychiatric disabilities encounter difficulties in the work setting due to cognitive impairments. This study will engage four programs in New York City providing supported employment and explore the feasibility and effectiveness of grafting on cognitive remediation interventions to supported employment services.

Cognitive remediation is concerned with a host of cognitive skills including memory, speed in handling tasks, and problem solving, to name a few. Using established neuropsychological evaluations and computer-based interventions designed to address such cognitive skills the staff to be engaged in this project will work to improve employment outcomes.

From the four employment programs in New York City we look to engage 80 consumers over the course of the year. These participating consumers well have the benefit of receiving neuro- psychological evaluations, the results of which will form the basis for subsequent cognitive remedial work.

The findings from these neuropsychological evaluations will also become an integral part of the employment planning at each site, as the results will be shared first with the consumer and then with the employment team. Finally, there will be available compensatory strategies to address cognitive competencies that need additional enhancement.

The principal investigator for this research is Susan McGurk who will oversee all aspects of the project. Dr. McGurk has written extensively on the subject of cognitive remediation. Dr. McGurk will be aided by a part-time research assistant who will be responsible for administering the neuropsychological battery of tests and providing feedback to consumers on their performance. Finally it is anticipated that from the four sites, eight employment personnel will be designated as cognitive rehabilitation specialists (CRS). These CRS will receive training on the delivery of cognitive remediation, will provide the cognitive interventions, and will be the liaison between the cognitive interventions and conventional supported employment services.

One measure of the program’s effectiveness is that consumers will have an increased employment rate — they will obtain and be able to sustain employment for a longer period of time — as measured against others in the supported employment program that are not participating in the cognitive remediation program.