Schizophrenia Treatment Services: Schizophrenia
Rehabilitation Program Description
The Schizophrenia Rehabilitation Program (SRP) provides state of the art
rehabilitation and treatment services to individuals with schizophrenia. These treatments use neuropsychological principles to
help patients improve their cognitive abilities and motivation. As these
skills are developed, the patients are then helped to improve the quality of
their lives by finding jobs or other meaningful and productive activity in
their communities.
In 1995, the Schizophrenia
Rehabilitation Center was opened to provide top quality long term
intensive neuropsychological and vocational rehabilitation for schizophrenia.Research conducted at The Institute of Living
and by other investigators over the last several years indicated that the
cognitive impairments associated with schizophrenia are partially responsible
for the chronic disability faced by these patients. Their poor concentration and
organization, memory deficits, and difficulty initiating and maintaining
behaviors make holding down a job or relating to others very difficult. These
cognitive deficits often remain even after treatment with anti-psychotic
medications and continue to impair the individual’s ability to function
effectively.
Research at the IOL (supported by Hartford
Hospital and the Spencer T. and Ann W. Olin Foundation) and at other cognitive
rehabilitation treatment and research centers indicate that some of these
deficits may be reduced through cognitive rehabilitation techniques. These
rehabilitation techniques require that patients repeat a series of drills to
practice their concentration, attention, memory, and problem solving.
The Schizophrenia Rehabilitation
Program provides highly specialized
training for individuals with schizophrenia, schizoaffective disorder, and other related
illnesses. The program provides patients with the opportunity for success in
daily endeavors and gradually builds upon these successes to improve their
adaptive functioning. The classes and individual instruction are designed to
educate patients about their illness and develop the skills necessary to
maintain productive and meaningful activity. The program offers three
specialty tracts:
The Early Intervention Track provides training and treatment for
individuals during the first few years of illness.
The Prolonged Illness Track provides training and treatment for individuals
with persistent and pervasive disabilities.
The Residential Trackprovides training and treatment for individuals
who require a long term or permanent supported living situation. Patients
participate in the training program while living in a group home on the hospital
grounds.
Summary of Program
In addition to traditional treatment services, SRP patients participate
in a variety of individual and group training programs that aim to improve
cognition, motivation, and interpersonal and vocational functioning.
At the onset of treatment, our multi-disciplinary team of psychiatric
clinical and rehabilitation professionals completes a comprehensive
assessment of the patients' strengths and weaknesses. This evaluation
includes diagnostic, neuropsychological , psychiatric,
psychopharmacological, functional, and vocational assessments. Some
evaluations are completed in the settings where the patients actually
function (e.g. home, work, etc.) These evaluations provide a platform for
the development of individual treatment plans. The patients’ families are
encouraged to maintain an active and ongoing involvement in the treatment,
through attendance at the Family Support Program and through family
consultations with the program’s staff.
Initially, patients attend the program at
least 3 days per week from 9:00 AM to 3:00 PM. During these days, the
patients participate in a variety of rigorous rehabilitation exercises that
promote increased motivation and concentration. When these abilities
improve, vocational counselors work with patients to obtain and maintain
jobs or education.
The rehabilitation day begins with the
Breakfast Club (Team Group). This session ensures that each patient
is oriented and focused on individualized, daily goals as each day begins.
Discussions led by staff focus on these goals and how to apply new skills
to achieve success in the day’s exercises.
Next, is the Motivation Group.
This training session is designed to promote motivation, teamwork, social
skills, and initiative. The patients participate in physical exercises
that require them to behave in a manner that fights against apathy and
inactivity.
The Cognitive Rehabilitation
Program follows this meeting. This program provides systematic
exercises to improve concentration, memory and other cognitive skills.
In the afternoon, the patients have
individual meetings with their therapists or Skills Training Therapy
Groups.
To finish this full day of
programming, the patients meet together for the Relaxation and
Compensatory Skills Group. In this therapy session, their
accomplishments are reinforced and they learn compensatory strategies to
apply their new skills to endeavors outside the program.
In addition, many patients participate
in the Vocational Program which includes vocational counseling, job
placement, and job coaching.
In addition to the ambulatory rehabilitation program and vocational
training experiences, the IOL operates a residential facility. This facility
provides long-term placement for a small number of individuals. Some
patients may live there on a relatively permanent basis, while others may be
able to move to more independent living situations after an extended stay.
The residential program was developed to help the patients compensate for
the cognitive and adaptive skills deficits associated with schizophrenia.
The program is located in the Buckingham Residence, a 13-bed group home
operating on The Institute of Living campus. This allows the SRP
Residential Track patients to socialize with other residents in the
Buckingham Program, while receiving extra services to meet their special
needs.
This program provides a home for
individuals who require a higher degree of structure and continuity to live
outside an inpatient unit, either due to their more substantial cognitive
deficits or long-term institutionalization. Initially, individuals in the
residential program attend the rehabilitation activities described above. In
addition to their attendance at the SRP day treatment services, the
Residential Track patients participate in daily physical exercise, personal
hygiene, diet and nutrition, and social and recreational activities at the
group home. As patients progress, vocational experiences are developed. The
long-term goal is for the home or community-based vocational activities to
replace the rehabilitation exercises, as the patients are more able to
maintain productive efforts on their own. The SRP rehabilitation
activities and residential activities of the Buckingham Program are fully
integrated to provide continuity for the patients.
In addition to
providing intensive neuropsychological and vocational rehabilitation, the SRP
maintains ongoing treatment outcome research to evaluate its programs. The
rehabilitation techniques applied in the SRP are systematically evaluated to
determine the most efficacious and efficient way to improve the individual's
quality of life. Objective evaluations are used to guide program development and
individual patients’ treatment plans. Patients may be asked to volunteer to
complete interviews or take tests as part of the research. Patient
participation in research projects is on a voluntary basis and patients can
receive treatment even if the do not wish to be involved in the research. For
copies of published articles about cognitive deficits in schizophrenia and
evaluations of the efficacy of these treatments, contact the program manager.
Brenner, H., Roder, V., Hodel, B., Kienzle, N., Reed, D. and
Liberman, R. (1994) Integrated Psychological Therapy for Schizophrenia
Patients, Hogrefe & Huber Publishers, Toronto.
Kern, R.S., Green, M.F. and Satz, P. (1992) Neuropsychological
Predictors of Skills Training for Chronic Psychiatric Patients, Psychiatry
Research, 43, 223-230.
Kurtz, M.M., Seltzer, J.C., Shagan, D.S., Thime, W.R., Wexler,
B.E. (2007) Computer-assisted Cognitive Remediation in Schizophrenia: What is
the Active Ingredient? Schizophrenia Research 89, 251-260.
Miran, M.C. and Miran E.R. (Unpublished manuscript)
Inside/Outside Program: Neuropsychological Therapeutic Treatment for Seriously
and Persistently Mentally Ill, Rochester, NY.
Seltzer, J., Cassens, G. & Conrad, C. (1997)
Neuropsychological Profiles in Schizophrenia: Paranoid Versus Undifferentiated
Distinctions, Schizophrenia Research 23, 131-138.
Seltzer, J.C., Kurtz, M.M., Thime, W.R. (2006) Schizophrenia
Rehabilitation Program at the Institute of Living: Combining Neurocognitive,
Motivational, and Vocational Rehabilitation. The Behavior Therapist,
Feb. 2006, 30-35.
Seltzer, J., Cassens, G., Ciocca, C., and O’Sullivan, L.
(1997) Neuropsychological Rehabilitation in the Treatment of Schizophrenia,
Connecticut Medicine, 61(9), 597-608.
Spaulding, W. (1992) Design Prerequisites for Research on
Cognitive Therapy for Schizophrenia, Schizophrenia Bulletin, 18(1),
39-42.
Spring, B. and Ravdin, L. (1992) Cognitive Remediation in
Schizophrenia: Should We Attempt It? Schizophrenia Bulletin, 18(1),
15-20.
For additional information or to request treatment, call Warren Thime,
Ph.D., Program Manager at 860-545-7680.
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The Schizophrenia Rehabilitation
Program provides highly specialized
training for individuals with schizophrenia, schizoaffective disorder, and other related
illnesses. The program provides patients with the opportunity for success in
daily endeavors and gradually builds upon these successes to improve their
adaptive functioning. The classes and individual instruction are designed to
educate patients about their illness and develop the skills necessary to
maintain productive and meaningful activity. The program offers three
specialty tracts:
