Pilot Testing CogSMART: A Novel, Compensatory Program of Cognitive Remediation for Psychosis developed by Elizabeth W. Twamley, PhD

Cognitive and social cognitive deficits affect nearly all individuals diagnosed with schizophrenia and have been shown to be a valid predictor of functional outcome. Great effort has been made in recent years to develop both pharmacological and non-pharmacological methods of mitigating these impairments. Cognitive remediation therapy (CR) has proven to be a reliable means of treating cognitive deficits in schizophrenia. Small to moderate effect sizes for improvements in various domains of cognition are consistently observed after treatment with CR. In strategic CR programs, clients are encouraged to become aware of cognitive deficits, set goals for improvement, and use strategies to compensate for impairments. In this pilot study, we aimed to assess the effectiveness of CogSMART, a strategic cognitive remediation program developed by Dr. Elizabeth Twamley at UCSD, in improving cognitive deficits for clients at the Gilead Community Services Social Rehabilitation Center in Middletown, CT. Five participants were initially enrolled in the study; however, two dropped out of the protocol at different time points and were excluded from our analysis. Changes in cognition, social cognition, and symptoms were assessed using a standardized battery of measures before and after completion of the program. We saw overall trends toward improvement and large effect sizes in the domains of verbal learning/memory, verbal fluency, attention/concentration, processing speed, working memory, social cognition and executive functions after completion of the CogSMART program. These results are encouraging and support continuation of the CogSMART program at Gilead and potentially beyond.