215. Action-Based Cognitive Remediation: Pairing Cognitive Training With Skill Development and CBT Principles

Abstract

Background: Most people with mental disorders experience a reduction of symptoms with treatment, but recovery of everyday functions is often delayed and incomplete. Cognitive Remediation is widely recognized as an effcacious treatment that improves attention, memory, and executive func-tions, but its ability to effectively promote behavior change is more limited and retention in treatment is often low. In response, we developed Action-Based Cognitive Remediation (ABCR) to build on intact procedural learning skills, pair neurocognitive training with skill-based training, and promote engagement in everyday behaviors considered cognitively chal-lenging. We sought to determine if ABCR was more effcacious (improved neurocognition) and more effective (improved functional skills and voca-tional outcomes) than traditional cognitive remediation. Methods: In this study, we compared ABCR to a traditional form of cognitive remediation in 50 participants with severe mental disorders. Treatment was 10 weeks, twice per week, in a group format. Both treatments provided computerized cognitive training, discussions of how to monitor and fexibly adapt strategies when solving problems, and discussions of how cognitive skills and strategies can be used in everyday life. Compared to traditional cognitive remediation, ABCR also included role-plays in simulated work tasks and goal setting with an emphasis on seeking cognitive challenge in everyday life. Results: Cognitive response was moderate to large and statistically signif-cant for both groups. and the ABCR group demonstrated larger improvements in a role-play measure of functional skills (P