RESEARCH WEEKLY: Cognitive Adaptation Training for People with Severe Mental Illness in Long-Term Care Settings
Cognitive training improves recovery outcomes in people with severe mental illness in long-term care settings, according to new research published this month. This study adds to the growing research available surrounding recovery-oriented care for those with severe mental illness.
The results bolster hope for people with severe mental illness and their families, particularly those who may require continuous care. The results from this study show that cognitive treatments may allow people to work towards living with more independence, regaining skills that were once lost.
The basics of Cognitive Adaptation Training
The study analyzed the effectiveness of Cognitive Adaptation Training (CAT) on participants when compared to treatment as usual in a long-term care facility. Cognitive Adaptation Training focuses on recovery-oriented treatment for those with serious mental illnesses in long-term care situations by attempting to improve problem solving, self-care, and other aspects of daily life.
CAT uses personalized assessments of each individual’s needs by a CAT-trained nurse, who then develops a bespoke treatment plan according to the results. The CAT techniques include setting up “environmental supports and rearrangements of belongings, to support people to achieve their individual goals and wishes.”
Improvements in major functioning skills
The researchers randomly placed people into two groups: those who would receive the CAT treatment and those who would receive treatment as usual. The people selected for the study were those “with a persistent psychiatric disorder that causes severe difficulties in multiple life domains and for whom coordinated longer-term care by professionals is necessary.”
After 12 months, the group who received the Cognitive Adaptation Training had improved daily functioning compared to the group who received treatment as usual. This improvement was measured through a variety of cognitive functioning tests, for example the Life Skills Profile, designed to assess functioning for people with schizophrenia by asking a series of questions like “Can this person generally prepare (if needed) his/her own food/ meals?”
Other tests also revealed improvements in executive functioning and visual attention for the participants who received the treatment. Executive function includes skills like memory, thinking, and self-control while visual attention refers to a person’s visual memory skills and ability to recognize patterns. The improvements in all three major categories were still maintained 24-months later, indicating that this type of cognitive training can have long-lasting effects.
However, it is important to note that not all the outcomes tested in the study showed improvement from the CAT treatment. Participants who received the Cognitive Adaptation Training did not show any improvement when tested for quality of life or level of empowerment. The participants also showed no significant reduction in the negative symptoms associated with their severe mental illness, like level of apathy, social interest, or attention.
Importance of the findings
People with severe mental illness that require intensive care have been largely ignored by the healthcare system for much of history because few professionals thought it was possible to reduce symptoms and work towards recovery, according to the study authors. Now, research shows cognitive training has the potential to improve the daily functioning of this population and people with severe mental illness can relearn certain skills and gain more independence.
Furthermore, this study implemented CAT into the daily routines of nurses and their patients without additional costs or time required. This could mean there is a no-cost treatment available for care facilities to implement with proven results. While healthcare funding continues to be sparse, it is important to look for more interventions that will cost little or nothing to enact.
