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Cognitive Behavioral Therapy and Work Outcomes: Correlates of Treatment Engagement and Full and Partial Success in Schizophrenia

Published online by Cambridge University Press:  21 June 2013

Marina Kukla ,
Louanne W. Davis  and
Paul H. Lysaker
Marina Kukla*
Affiliation:
Roudebush VA Medical Center, and Indiana University-Purdue University, Indianapolis, USA
Louanne W. Davis
Affiliation:
Roudebush VA Medical Center and Indiana University School of Medicine, Indianapolis, USA
Paul H. Lysaker
Affiliation:
Roudebush VA Medical Center and Indiana University School of Medicine, Indianapolis, USA
*
Reprint requests to Marina Kukla, Roudebush VA Medical Center, 1481 W. 10th Street, Indianapolis, IN 46202, USA. E-mail: [email protected]
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Abstract

Background: Cognitive behavior therapy (CBT) has been found to be generally effective for persons with schizophrenia. Less is known however about those who will engage in this treatment, and among those who engage, who benefits more versus less from this intervention. Aims: This study sought to identify factors associated with treatment engagement and response in persons with psychosis engaged in CBT focused on enhancing work function. Method: Participants were 50 adults with schizophrenia-spectrum disorders participating in a randomized control trial that offered both CBT and a protected employment position over 26 weeks. Survival analysis and discriminant analyses were used to analyze the data. Results: Results indicated that poor treatment engagement and engagement in work was associated with lower educational attainment, more severe baseline levels of negative symptoms, and lower baseline scores on the Arithmetic and Digit Symbol subscales of the WAIS-III. Amongst those participants who did engage, younger age and poorer working memory as assessed by the Arithmetic subscale predicted shorter initial job tenure. More severe levels of positive symptoms and lower self-esteem during the later stages of treatment were associated with worse employment outcomes across the study period. Conclusions: These findings evidence differential predictors of engagement and success and suggest that a subgroup of persons with schizophrenia engaged in CBT and a vocational placement are at risk for poor functional outcomes associated with psychological factors that evolve over time.

Keywords

Cognitive behaviour therapyschizophreniasymptomsself esteem
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 42 , Issue 5 , September 2014 , pp. 577 - 592
Creative Commons
This is a work of the U.S. Government and is not subject to copyright protection in the United States.
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013

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