Cognitive enhancement interventions in individuals with severe mental illness can reduce impairments that are barriers to working, according to a randomized, controlled trial.

Of 107 subjects with severe mental disorders evaluated, 46% had schizophrenia or schizoaffective disorder. They had not obtained or been able to keep employment even when receiving support.

They were assigned to received either enhanced support from employment specialists who were given cognitive training, or enhanced support plus the Thinking Skills for Work program. The program offers cognitive enhancement that includes computer cognitive exercises, strategy coaching, and teaching of coping and compensatory strategies.

Researchers tracked employment weekly for 2 years. Blinded assessors evaluated cognitive functioning at baseline, after training, and at 12 and 24 months after baseline.

Those who were part of the Thinking Skills program had better cognitive functioning scores than those in the comparative group. They also had better employment outcomes, including:

• Jobs obtained: 60% vs 35%

• Weeks worked: 23.9 vs 9.2

• Wages: $3421 vs $1728

Citation: McGurk S, Mueser K, Xie H, et al. Cognitive Enhancement Treatment for People With Mental Illness Who Do Not Respond to Supported Employment: A Randomized Controlled Trial. Am J Psychiatry. 2015;172(9):852-861.