Integrating Shaping and Skills Training Techniques in the Treatment of Chronic Treatment Refractory Individuals with Schizophrenia

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

“…In sum, our findings add to the growing body of literature (Menditto, Baldwin, & O'Neal, 1991; Silverstein et al, 2005; Silverstein et al, 1998; Silverstein et al, 2009; Silverstein et al, 1999; Spaulding, Storms, Goodrich, & Sullivan, 1986) demonstrating that ASP profoundly improves attention in people diagnosed with schizophrenia who have marked impairments. Further, across multiple metrics of various constructs related to attention, cognition, social and functional skills, and learning, we found that ASP leads to meaningful improvements.…”

“…Moreover, for the first time, ASP was shown to be an effective intervention in a partial hospital setting and the effects of ASP were shown to extend beyond the immediate treatment context to other groups and to influence, among other things, neuropsychological test performance and participants' ability to learn. Given the consistency and magnitude of its effects for people with schizophrenia regardless of their background characteristics and symptom profiles, we believe all people with schizophrenia who have attentional impairments should be offered ASP whether to augment psychosocial groups (Menditto, Baldwin, & O'Neal, 1991; Silverstein et al, 2005; Silverstein et al, 1998; Silverstein et al, 2009; Silverstein et al, 1999; Spaulding, Storms, Goodrich, & Sullivan, 1986) or computer-based remediation efforts (Combs et al, 2008). To be sure, at present, ASP is underutilized: few treatment programs, whether inpatient or partial hospitals, use ASP, despite the large number of people with schizophrenia who continue to demonstrate limited response to treatment.…”

“…Moreover, these programs are not designed for, and are rarely used with, people with the most severe attentional impairments. In contrast, a type of cognitive remediation called attention shaping procedures (ASP) has been consistently demonstrated to improve attentional capacity and treatment engagement even in people diagnosed with schizophrenia who are the most chronically ill and have attentional impairments (Menditto, Baldwin, & O'Neal, 1991; Silverstein et al, 2005; Silverstein et al, 1998; Silverstein et al, 2009; Silverstein et al, 1999; Spaulding, Storms, Goodrich, & Sullivan, 1986). …”

“…Participant progress is reinforced through verbal praise and tangible reinforcers. A large body of research (e.g., Menditto, Baldwin, & O'Neal, 1991; Silverstein et al, 2005; Silverstein et al, 1998; Silverstein et al, 2009; Silverstein et al, 1999; Spaulding, Storms, Goodrich, & Sullivan, 1986) has demonstrated that ASP improves attention, task performance, and skill acquisition from psychosocial groups, regardless of individual differences in symptom type or severity, and intelligence.…”

Techniques pour améliorer l’attention et l’engagement dans le traitement des patients souffrant de schizophrénie avec de graves déficits cognitifs (troisième partie)

“…Ils ont continué à avoir de bonnes performances dans ces classes, puisqu'au terme d'une année de suivi, ils réussissaient leurs devoirs scolaires à 84 % du temps. Des résultats semblables ont été rapportés par Bellus et al (1998) en utilisant des procédures similaires à celles de Menditto et al (1991) et par Silverstein et al (1998b Silverstein et al (1999) ont démontré l'efficacité de cette approche intégrative de l'entraînement des habiletés/façonnement. Tous les participants ont démontré des améliorations du comportement attentif par cette procédure.…”