Project 461776

Cognitive behavioural therapy (CBT) is a psychological intervention designed to specifically target the positive and negative symptoms of schizophrenia-spectrum disorders with the ultimate goal of improving community functioning and well-being. Cognitive remediation (CR) is another psychological intervention designed to improve community functioning through a pathway of improving neurocognitive abilities, such as attention, memory, and executive functioning. Both CBT and CR improve their respective mechanisms (positive / negative symptoms, and neurocognition), however, effects on functional recovery are more limited. The proposed randomized controlled trial aims to examine whether a combined CBT and CR intervention is significantly more effective for improving community functioning than either intervention delivered alone. Additionally, treatment effects on secondary outcomes such as personal recovery, quality of life, positive symptoms, negative symptoms, neurocognition, and electrophysiology will be examined. Lastly, therapeutic mechanisms will be examined in all treatment arms to examine underlying mechanisms of improvement from the interventions. 360 individuals with schizophrenia-spectrum disorders will be randomized to receive either CBT and sham CR, CR and befriending, or CBT and CR. Sham CR and befriending serve as control conditions to control for the amount of time spent in therapeutic contact. All participants will receive one hour of individual therapy (CBT or befriending) and one hour of group therapy (CR) per week for 30 weeks. All participants will be assessed at baseline, posttreatment, 6-months post-treatment, and 12-months post-treatment. Results from this study will inform best practice psychosocial interventions to improve recovery in schizophrenia-spectrum disorders, and provide a combined CR and CBT intervention.