Innovations: Rehab Rounds: Problem-Solving Skills for Cognitive Rehabilitation Among Persons With Chronic Psychotic Disorders in Italy

Abstract

Studies have shown that teaching persons with mental illness to identify and cope with their real-life problems yields substantial clinical improvements. In Italy a structured problem-solving group was established in a day treatment center in 2003. This column describes the approach and focuses on the outcomes achieved by 15 patients with severe mental illness who were in this group. After completion of the problem-solving program, significant improvements were noted in symptom scores on the Positive and Negative Syndrome Scale and in problem-solving and neurocognitive test performance, with further improvements six months after completion of the group sessions. Problem-solving training may contribute to improved neurocognition and symptoms.

A Comparison of the Effectiveness of Problem Solving Training and of Cognitive-Emotional Rehabilitation on Neurocognition, Social Cognition and Social Functioning in People with Schizophrenia

“…We followed Fallon unpublished manual [ 23 ] very similar to that of Barbieri, et al [ 24 ]. A structured method of resolving problems, such as PST, allows patients with schizophrenia to develop solutions to everyday problems, by assigning them a role of responsibility and allowing individuals to experience an active management of the problems themselves.…”

“…For the PST , we followed the Falloon approach [ 23 ] better decribed in an unpublished manual that is quite similar of that edited by Barbieri et al [ 24 ].…”

Role of Executive Function in Response to a Problem Solving Based Psychoeducational Intervention in Adolescents with Psychosis: The PIENSA Trial Revisited

“…In addition, improvements in verbal memory and executive functions with median to large effect sizes have been observed in cognitive remediation approaches for adolescent psychosis together with improvements in daily living, adaptive functioning, and family burden [57]. Furthermore, particular improvements in verbal fluency measures, together with significant positive and negative symptom reductions, have also been observed in specifically targeted problem-solving program interventions [58]. Verbal fluency performance has shown to be one of the most impaired cognitive functions in first-episode schizophrenia patients and individuals at ultra-high-risk for psychosis (i.e., specifically semantic verbal fluency [59] and one of the best cognitive predictors for psychosocial functioning [60]).…”

Problem solving training for schizophrenia: Rationale and review

“…The fourth study was conducted in day treatment centres and showed significant clinical and neurocognitive benefits after 6 months (Table II). These were also significantly greater than those assessed in a cohort participating in manual activities of over a similar period (Barbieri et al, 2006). All four Italian centres have used the same manual for the problem solving training (Falloon, 2000b) and have expressed interest in controlled trials of the methods.…”

“…It is divided into 4 phases dealing with the real life problems of the group members of increasing cognitive complexity and emotional distress (Barbieri et al, 2006). An initial orientation includes education about schizophrenia and its treatment, development of relapse prevention plans to detect and respond to early signs of exacerbation, clarifying specific personal life goals and defining a list of problems that represent the major obstacles to overcome in the achievement of those goals.…”