Cognitive Enhancement Therapy (CET)
Cognitive Enhancement Therapy (CET) is an Evidence-Based Practice designed to help people with schizophrenia and related cognitive disorders improve brain and cognitive development, social cognition, and increase vocational capabilities. Cognition is the major source of disability for persons who are recovering from mental illnesses and CET targets cognitive deficits that limit recovery. While medication for most people in recovery is needed they are not really effective in improving cognition.
CET was developed by Prof. Gerard Hogarty and Samuel Flesher, PhD at the EPICS Program at the University of Pittsburgh Medical School. The initial CET research was funded by a National Institute of Mental Health grant using a rigorous methodology, including 121 subjects over three years (Archives of General Psychiatry, Sept. 2004). Subsequent research has continued to demonstrate the durability of CET and its applicability to early course schizophrenia:
- A study by Shaun Eack, et al, shows the effectiveness of CET as a vocational intervention
- The meta-analysis by Til Wykes, et al, found that “significantly stronger effects on functioning were found when cognitive remediation therapy was provided together with other psychiatric rehabilitation in a much larger effect was present when a strategic approach was adopted together with adjunctive rehabilitation”. . . “Conclusions: cognitive remediation benefits people with schizophrenia and when combined with psychiatric habilitation, this benefit generalizes to functioning, relative to rehabilitation alone.“
CET Focuses on Social Cognition
Impairments to brain function such as attention, memory and problem solving can seriously affect social cognition (e.g. being able to take others’ perspectives, cognitive flexibility, getting the gist). CET consists of 48 weekly sessions:
- Neuro-cognitive computer exercises conducted in pairs and supervised by CET Coaches
- Highly structured, closed groups of 8 to 12 individuals conducted by CET coaches consisting of:
- Interactive Social Cognition Discussions
- Homework reporting in class
- Cognitive exercises done in pairs
- Individual ‘coaching’ once a week
- 30-60 minute individual coaching to work on homework assignments and to clarify questions asked in the CET group.
Attendance rates average 85 to 90% at all sites; graduation rates average 85%.
What makes CET unique?
- Holistic, rehabilitation orientation
- Specific topics are assigned each week and group members are expected to focus on that topic.
- Coaches give group members intellectual and emotional problems to solve.
- CET is curriculum-driven and theory-based
- Staff are referred to as Coaches.
- Highly structured group.
Benefits of Cognitive Enhancement Therapy
- Awareness of social context
- Vocational effectiveness
- Interpersonal effectiveness
- Active Thinking
- Awareness of illness/disability
- Perspective Taking
- Cognitive Flexibility