Schizophrenia: Understanding and Comparing Cognitive Enhancement and Social Skills training
About
About Our Project
Project SUCCESS is a comparative effectiveness study of two evidence-based psychosocial interventions for people with schizophrenia or schizoaffective disorders: Cognitive Enhancement Therapy (CET) and a form of Social Skills Training called Helping Ourselves Pursue and Experience Success (HOPES). Both treatments improve social and community functioning and so help participants achieve more of their potential.
We adapted to the massive social dislocations resulting from the pandemic by engaging flexibly with our treatment sites as they confronted new challenges. We are now supporting effective delivery and rigorous testing of CET and HOPES at more than 20 sites in nine states.
In addition to enhancing the lives of our treatment participants, our comparative effectiveness analysis will help service providers make the most effective decisions about treatment options for their clients.
Our Team
We are an interdisciplinary research team led by psychiatrist Matcheri Keshavan, MD and sociologist Russell Schutt, PhD in the Department of Psychiatry, Beth Israel Deaconess Medical Center and the Harvard Medical School. Our co-investigators are distinguished researchers from our own department and from Boston University, Dartmouth College and Dartmouth-Hitchcock Medical Center, and the University of Pittsburgh. Stakeholder engagement in our research is led by national consumer advocate Jon Delman, MPH, JD, PhD, University of Massachusetts Medical School. Site Principal Investigators are research and program leaders at their home institutions. Our team also includes talented research assistants, clinicians, and administrative staff.
Approach
Our Research Approach
This study is a multi-site cluster randomized comparative effectiveness trial investigating the relative efficacy of two proven therapies to better inform treatment decisions of clinicians, clients, and stakeholders.
Methodology
Approximately 20 treatment sites randomly assigned to delivery CET or HOPES. The treatment is usually comprised of 2 Master's-level clinicians who work with and are support by a Site PI and a Site RA, project treatment experts, and research staff at BIDMC. Project treatment experts train the Site clinicians in the treatments in 4 half-day remote sessions and then supervise the clinicians in weekly review sessions. Each site enrolls 6-8 clients per treatment group and each group meets for one year.
Recruiting
Potential clients are identified at participating service sites or respond to a project flyer and are then asked about their interest by site staff. Those who are interested and meet basic eligibility criteria participate in a formal consent session led by BIDMC project staff via secure video conferencing. Those who consent are screened for diagnostic eligibility.
Eligibility criteria: 18-65 years of age; diagnosis of schizophrenia, schizoaffective disorder, or schizophreniform disorder; no diagnosed organic brain disorder or intellectual disability; have not participated in either CET or SST within preceding year.
Clinical
The two treatments being compared, CET and HOPES, are each aimed at improving social and community functioning and quality of life in individuals diagnosed with schizophrenia, schizoaffective, or schizophreniform disorder.
CET (Cognitive Enhancement Therapy) combines a group-based social curriculum with cognitive training exercises done in pairs with clinician support, as well as individual therapy.
HOPES (Helping Ourselves Pursue and Experience Success) is a type of Social Skills Training that combines a group-based social curriculum with group-based role play of social interactions and engagement of a community support person to encourage exploration and mastery of the social skills.
Assessment Protocol
Once enrolled, all participants are assessed at baseline and every 6 months for 2 years, via secure video conference, by BIDMC research staff who are blind to treatment assignment. Data are also recorded on treatment participation. Participants receive a monthly satisfaction survey to complete online.
Funding
ACKNOWLEDGMENT: This work is supported through a Patient-Centered Outcomes Research Institute (PCORI) Award (CER-2018C3-14701).
DISCLAIMER: All statements in this site are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute (PCORI), its Board of Governors or Methodology Committee.
Our Location
Beth Israel Deaconess Medical Center
330 Brookline Ave
Boston, MA
United States
02215