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New treatment study teaches older adults with schizophrenia to set and achieve personal goals

One of the biggest issues for seniors with severe mental illness is getting help with the little, everyday things, such as having a conversation.

“What they miss, having had an illness for a number of years, is talking about everyday issues and problem-solving,” explained Dr. Tarek Rajji, Chief of Geriatric Psychiatry.

After noticing that medication had little effect on changing how patients functioned in social settings, Dr. Rajji was inspired to start a new project that treated some of the social challenges associated with the schizophrenia.

“Folks need to be able to maintain meaningful relationships. Also, it’s important for them to be able to talk to different people in their lives, such as doctors, social workers and landlords,” he said. “We wanted to help them maintain a certain level of independence.”

Dr. Rajji, who is also a clinician-scientist in the Campbell Family Mental Health Research Institute, started a treatment study aimed at improving social functioning in older patients with schizophrenia. Throughout the nine-month intervention, participants undergo weekly Cognitive Behavioural Social Skills Training, which consists of sessions that focus on healthy thinking and problem-solving.

“For most of them, this experience is probably the first time they’ve experienced this sort of therapeutic approach,” explained Dr. Rajji. “Many patients may have had individual therapy or been part of unstructured groups. This new CAMH research program is the first to collect evidence to see whether this type of structured social skills group-learning works in older adults with schizophrenia.”

What’s more, seniors with schizophrenia tend to less or stable psychosis, making older age an ideal stage to focus on rehabilitation.

So far, researchers have worked with 60 participants and are looking to include a few more individuals to complete this study. All participants are at least 60 years of age, and have a specific personal goal in mind, which could be losing weight or making more friends. Following each session, individuals must complete homework and report on their progress.

Participants will also complete a computerized training program aimed at improving memory and attention.  The program — which is also known as computerized cognitive remediation — involves completing a series of memory and problem-solving tasks.

This study was funded in part by the Ontario AFP Innovation Fund (Alternative Funding Program). If the results are promising, the researchers plan to run a larger trial that will incorporate other therapies, such as non-invasive brain stimulation. So far, the feedback from participants has been positive.

“They really enjoy it,” he said. “It’s not just about learning skills. It’s also about achieving things.”​​​

 

 Related links

 
​​Read Dr. Tarek Rajji's blog ​on other current research in geriatric psychiatry at CAMH (Jan 2013)
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