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Zalzala A, Fiszdon JM, Moritz S, Wardwell P, Petrik T, Mathews L, Shagan D, Bracken D, Bell MD, Pearlson GD, Choi J. Metacognitive Training to Improve Insight and Work Outcome in Schizophrenia. J Nerv Ment Dis 2022; 210:655-658. [PMID: 36037322 PMCID: PMC9424738 DOI: 10.1097/nmd.0000000000001512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Individuals with psychotic disorders have deficits in metacognition. Thirty-four adults with schizophrenia were randomized to 2 months of metacognitive training (MCT) or a healthy living skills control group. All participants were enrolled in a work therapy program, followed by a supported employment program. Assessments were conducted at baseline, at the end of the 2-month active intervention, and at 4- and 12-month follow-ups. At the end of active intervention, the MCT group demonstrated greater improvement and better work behavior relative to controls. At follow-up, the MCT group demonstrated significantly greater insight and fewer positive symptoms and a greater percentage were employed in the community. We speculate that being better able to think about one's thoughts, recognize biases in thinking, and correct those thoughts may aid in responding to workplace challenges and hence improve work outcomes.
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Affiliation(s)
- Aieyat Zalzala
- The Institute of Living, Hartford Healthcare Behavioral Health Network, 200 Retreat Ave, Hartford, CT USA
| | - Joanna M. Fiszdon
- Psychology Service, VA Connecticut Healthcare System
- Department of Psychiatry, Yale University School of Medicine
| | | | - Patricia Wardwell
- Department of Psychiatric Vocational Services, The Institute of Living, Hartford Healthcare Behavioral Health Network
| | - Tammy Petrik
- Department of Psychiatric Vocational Services, The Institute of Living, Hartford Healthcare Behavioral Health Network
| | - Laura Mathews
- Department of Psychiatric Vocational Services, The Institute of Living, Hartford Healthcare Behavioral Health Network
| | - Dana Shagan
- The Institute of Living, Hartford Healthcare Behavioral Health Network, 200 Retreat Ave, Hartford, CT USA
| | | | - Morris D. Bell
- Psychology Service, VA Connecticut Healthcare System
- Department of Psychiatry, Yale University School of Medicine
| | - Godfrey D. Pearlson
- Department of Psychiatry, Yale University School of Medicine
- Olin Neuropsychiatry Research Center, Hartford Healthcare Behavioral Health Network
| | - Jimmy Choi
- The Institute of Living, Hartford Healthcare Behavioral Health Network, 200 Retreat Ave, Hartford, CT USA
- Olin Neuropsychiatry Research Center, Hartford Healthcare Behavioral Health Network
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Mervis JE, Fiszdon JM, Lysaker PH, Nienow TM, Mathews L, Wardwell P, Petrik T, Thime W, Choi J. Effects of the Indianapolis Vocational Intervention Program (IVIP) on defeatist beliefs, work motivation, and work outcomes in serious mental illness. Schizophr Res 2017; 182:129-134. [PMID: 27802910 PMCID: PMC5828005 DOI: 10.1016/j.schres.2016.10.036] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/23/2016] [Accepted: 10/27/2016] [Indexed: 11/15/2022]
Abstract
Defeatist beliefs and amotivation are prominent obstacles in vocational rehabilitation for people with serious mental illnesses (SMI). The CBT-based Indianapolis Vocational Intervention Program (IVIP) was specifically designed to reduce defeatist beliefs related to work functioning. In the current study, we examined the impact of IVIP on defeatist beliefs and motivation for work, hypothesizing that IVIP would be associated with a reduction in defeatist beliefs and greater motivation for work. We also examined the effects of IVIP on these variables as well as work outcomes during a 12-month follow-up. Participants with SMI (n=64) enrolled in a four-month work therapy program were randomized to IVIP or a support therapy group (SG). Assessments were conducted at baseline, post-treatment (4months), and follow-up (1year). Compared to those in SG condition, individuals randomized to IVIP condition reported greater reductions in defeatist beliefs and greater motivation for work at follow-up, along with greater supported employment retention rates. Specifically treating and targeting negative expectations for work therapy improves outcomes, even once active supports of the IVIP program and work therapy are withdrawn.
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Affiliation(s)
- Joshua E. Mervis
- Department of Psychology, University of Minnesota, 75 East River Road, Minneapolis, MN, USA,Corresponding author
| | - Joanna M. Fiszdon
- Psychology Service, VA Connecticut Healthcare System & Yale University School of Medicine, 950 Campbell Ave, West Haven, CT 06516 USA
| | - Paul H. Lysaker
- Roudebush VA Medical Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tasha M. Nienow
- Minneapolis VA Health Care System, 1 Veterans Dr., Minneapolis, MN 55417 USA
| | - Laura Mathews
- Department of Psychiatric Vocational Services, The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA.
| | - Patricia Wardwell
- Department of Psychiatric Vocational Services, The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA.
| | - Tammy Petrik
- Department of Psychiatric Vocational Services, The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA.
| | - Warren Thime
- Schizophrenia Rehabilitation Program, The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA.
| | - Jimmy Choi
- Schizophrenia Rehabilitation Program, The Institute of Living at Hartford Hospital, 200 Retreat Ave, Hartford, CT 06106, USA.
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