Introduction to Cognitive Enhancement Therapy (CET)

Cognitive Enhancement Therapy is a comprehensive and evidence-based cognitive remediation program for supporting individuals with schizophrenia in taking the next steps in their recovery. The therapy was originally developed by Prof. Gerard E. Hogarty, MSW at the University of Pittsburgh Department of Psychiatry out of growing appreciation for the cognitive challenges schizophrenia introduces and their impact on important recovery outcomes, including employment and successfully navigating social situations.

The onset of schizophrenia, usually in the late teens or early 20s, is a critical time for brain development. This is the window when some of the most advanced maturation of the social and problem-solving centers of the brain occur, which allow humans to take on increasingly socially and cognitively complex roles in adulthood. It is also a time when many are starting to chart their path toward a career, permanent partnerships, and other important social milestones. The onset of schizophrenia during this time often disrupts these important social and cognitive milestones, and individuals can feel stuck in pursuing their life and recovery goals.

Cognitive Enhancement Therapy or CET is designed to jump-start this developmental process by providing individuals with schizophrenia with enriched experiences from which they can grow socially and cognitively, to further reach their personal recovery goals. CET is not like typical therapy, but more akin to a class where participants work on social and cognitive exercises to build mental stamina, increase ability to take the perspective of others, and apply new strategies to enhance thinking and success in social situations.

The main activities in CET are computer training and a social-cognitive group. In computer training, participants work with another partner living with schizophrenia and a coach to increase processing speed, build attention, strengthen working memory, and increase problem-solving and planning. These exercises are like working out at the gym, but for the brain, and studies have shown that repeatedly engaging with the exercises can rewire neurons and enhance thinking in many meaningful ways. The social-cognitive group is similar in principle to computer training, except that it provides a workout for the social brain. Rather than engaging in exercises on the computer, 6-8 participants come together to form a group where they learn and practice ways to understand and act wisely in social situations, such as understanding the social context, picking up social cues, taking the perspectives of others, getting the gist out of social situations.

These activities are delivered over the course of a year in Project SUCCESS because we know that when people with schizophrenia have sustained support for their recovery, incredible progress is possible. Those participating in CET also meet weekly with their therapist/coach to tailor the program to their unique needs and recovery goals. All participants in CET develop, in collaboration with their coach, recovery plans to help guide their work in the program and focus on the areas that are most important to their own personal recovery.

We have been delivering CET to help individuals with schizophrenia jump-start their recovery for over 20 years, and on a personal note, each one of us has seen the value in this approach for individuals with schizophrenia and ourselves. We have seen countless individuals make achievements and progress that others thought were not possible, and perhaps one of our favorite aspects of CET is how common it is for people to surprise themselves and others in the gains they can make. We look forward to helping participants start the next chapter in their recovery.

Shaun, Maralee, Luis, Kesh

Shaun Eack, PhD, Maralee Litschge, MSW, Luis Sandoval, PhD, & Matcheri Keshavan, PhD