Cognitive Remediation for Coordinated Specialty Care

Paused · Not applicable

Conditions studied: Schizophrenia, Schizoaffective Disorder

In brief

Cognitive remediation (CR) is an evidence-based behavioral skills intervention that targets the cognitive processes underlying functioning in everyday life. It can be used as part of early intervention to reduce cognitive deficits evident at the first episode of psychosis, and has the potential to impact recovery and quality of life. Across Coordinated Specialty Care (CSC) programs, about half of early psychosis participants do not achieve sustained vocational, educational, and/or social recovery; adding CR to CS programs could improve these outcomes. However, models of CR need to be adapted to meet the developmental needs of a younger population and to better fit the CSC model of service delivery. This study of CR implementation will be conducted within the context of OnTrackNY, a network of first-episode psychosis programs that currently offers basic cognitive health evaluation and supportive treatment but not CR. Intervention content will be designed and refined based on input from multiple stakeholders. The study will assess two delivery approaches to CR, one that delivers CR exclusively "in-clinic/clinician-led" and the other that is "partial-remote/independent" with one in-clinic/clinician-led session per week plus out-of-clinic independent cognitive practice. Nine OnTrackNY programs will be selected and OnTrackNY clinicians will be trained to conduct a cognitive assessment battery and CR. Three programs will be randomly assigned to provide treatment as usual (TAU) and six programs will be randomly assigned to provide both TAU and CR (either "in-clinic/clinician-led" or "partial-remote/independent"). Using de-identified data collected routinely by OnTrackNY for quality improvement/program evaluation, the investigators will examine whether the addition of CR improves functional outcomes for clients with first-episode psychosis, compare the effectiveness of CR delivery methods, and explore whether cognitive improvement is associated with improvement in functioning.

Key facts

Study ID

NCT03930251

Run by

New York State Psychiatric Institute

People needed

117

Starts

2019-06-01

Expected to finish

2026-08-31

Last updated by the study team

2025-10-07

Who can join

Age: 18 and older, up to 30. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Enrolled in a participating OTNY cognitive remediation program

You may not qualify if…

• Not eligible to be enrolled in a participating OTNY cognitive remediation program

Where it is running

• Kings County Hospital Center — Brooklyn, New York, United States
• Services for the Underserved — Brooklyn, New York, United States
• Bellevue Hospital Center — New York, New York, United States
• Washington Heights Community Service — New York, New York, United States
• Elmhurst Hospital Center — Queens, New York, United States
• Rochester Psychiatric Center — Rochester, New York, United States
• Staten Island University Hospital — Staten Island, New York, United States
• The Institute for Family Health — The Bronx, New York, United States
• Montefiore Medical Center — The Bronx, New York, United States

Full record on ClinicalTrials.gov

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