BRIDGING SKILLS: LINKING COGNITIVE REMEDIATION TO OCCUPATIONAL PERFORMANCE

Introduction: Cognitive impairment is a core component of schizophrenia negatively affecting occupational performance. Cognitive Remediation Therapy (CRT) aims to improve these cognitive deficits. The goal is durability and... [ view full abstract ]

Introduction:
Cognitive impairment is a core component of schizophrenia negatively affecting occupational performance. Cognitive Remediation Therapy (CRT) aims to improve these cognitive deficits. The goal is durability and generalization.
CRT has been practiced in Helsinki University Hospital (HUH), Psychiatry Unit since 2006. Transferring the gained skills durably to general functioning has been challenging.

Aim:
We propose combining Occupational Therapy to CRT. An occupational therapists understanding of the relationship between the clients roles, daily occupations and context gives a unique frame of reference for transferring gained skills to general functioning in everyday settings. The ultimate goal is the clients increased awareness and use of global strategies promoting occupational performance.

Method:
Occupational therapy alongside CRT give the client an opportunity to create new routines through repetitively practicing acquired cognitive skills and strategies in meaningful everyday settings. Activities are chosen with the client in accordance with individual goals to address specific perceived challenging tasks. Perceived self-competency is achieved through careful analysis of occupational performance. During activity the therapist reminds of and encourages use of strategies learned in CRT. The occupational therapist explains and models how specific cognitive functions impact occupational performance and how the client can overcome daily challenges using strategies learned in CRT.

Discussion:
Studies evaluating efficacy of CRT emphasize mediators such as motivation, volition, sense of mastery and use of meaningful, daily activities, all core competency of an occupational therapist, as favorable for a good functional outcome. Occupational therapy gives an outstanding possibility for bridging skills between CRT and occupational performance.