Enhancing and Promoting Recovery in Attentionally Impaired People Diagnosed with Schizophrenia: Results From a Randomized Controlled Trial of Attention Shaping in a Partial Hospital Program

Abstract

The attentional impairments associated with schizophrenia are well documented and profound. Psychopharmacological and most psychosocial interventions have been shown to have limited effect in improving attentional capacity. That said, one form of psychosocial treatment, attention shaping procedures (ASP), has been repeatedly demonstrated to produce significant and meaningful change in various aspects of participant attentiveness behaviors. To date, studies of ASP have been limited in that they have been conducted primarily with inpatients, have not assessed the generalizability of ASP's effects, and have not explored whether reinforcement is required to be contingent on performance of attentive behaviors. To address these limitations, we conducted the first randomized clinical trial of ASP with people diagnosed with schizophrenia who were being treated in a partial hospital program. Our results indicate that ASP is effective in improving attention in people with schizophrenia in these types of programs, the effects of ASP generalize outside the immediate treatment context to both other treatment groups and real-world functioning, and contingent reinforcement is a critical ingredient of ASP. This project provides further evidence for the benefits of use of ASP in the recovery-oriented treatment of people diagnosed with schizophrenia who have significant attentional impairments.

Keywords:

• Attention
• Behavior therapy
• Cognitive remediation
• Recovery-oriented care
• Schizophrenia
• Serious mental illness

ACKNOWLEDGMENTS

We thank Debby Hartley, Kara Biondo, Payal Pandya, Danielle Seraile, Travis Bess, and Jay Jeschke for their assistance with data collection and clinical service provision for this project. We also thank administration and clinical staff at Rutgers University Behavioral Health Care for their dedication to, and support of, this project.