Browsing by Author "Bell, Morris D."

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    Decisional Informatics for Psychosocial Rehabilitation: A Feasibility Pilot on Tailored and Fluid Treatment Algorithms for Serious Mental Illness
    (Wolters Kluwer, 2017-11) Choi, Jimmy; Lysaker, Paul H.; Bell, Morris D.; Dixon, Lisa; Margolies, Paul; Gold, Matthew; Golden-Roose, Elizabeth; Thime, Warren; Haber, Lawrence C.; Dewberry, Michael J.; Stevens, Michael; Pearlson, Godfrey D.; Fiszdon, Joanna M.; Medicine, School of Medicine
    This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility. Of participants who identified obtaining a General Education Diploma as their goal, 73% in FORT passed the examination compared with 18% in traditional treatment planning. FORT was also associated with higher agency cost-effectiveness and a better average benefit-cost ratio, even when considering diagnosis, baseline symptoms, and education. Although the comparison groups were not completely equivalent, the findings suggest computerized decision support systems that collaborate with human decision-makers to personalize psychiatric rehabilitation and address critical decisions may have a role in improving treatment effectiveness and efficiency.
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    A randomized controlled trial examining a cognitive behavioral therapy intervention enhanced with cognitive remediation to improve work and neurocognition outcomes among persons with schizophrenia spectrum disorders
    (Elsevier, 2018-07) Kukla, Marina; Bell, Morris D.; Lysaker, Paul H.; Psychology, School of Science
    This single blind, three-armed randomized controlled trial compared cognitive behavioral therapy (CBT) enhanced with cognitive remediation (CBT + CR) to CBT alone and an active control condition on work and neurocognition outcomes for persons with schizophrenia spectrum disorders. Seventy-five adult outpatients with schizophrenia or schizoaffective disorder were randomized to three study conditions (N = 25 per group). The CBT intervention was the Indianapolis Vocational Intervention program (IVIP), consisting of weekly group and individual sessions focused on work-related content. Participants in the CBT + CR group received IVIP and Posit Science computer-based cognitive training. The active control group consisted of weekly vocational support groups and individual vocational support sessions. All participants were placed into a noncompetitive work assignment and were followed for 26 weeks. Data collection included hours worked, weekly work performance ratings, and neurocognition assessed at baseline and 6 months. Neurocognition was also assessed at 12 months. Data were analyzed using multilevel linear models to account for nested, repeated measures data. Results indicate that participants in the CBT + CR condition worked significantly more hours and had a more positive trajectory of improving global work performance and work quality across the study compared with the CBT alone and vocational support condition. Compared to the other conditions, CBT + CR also had a significant increase in overall neurocognition that continued to the 12 month follow-up, particularly in the domains of verbal learning and social cognition. In conclusion, CBT + CR may be an effective intervention to improve work functioning and neurocognition in persons with schizophrenia.