Is there a synergistic effect of adding social cognition remediation to cognitive remediation therapy in young people? A randomised controlled trial

INTERVENTION: 2 arms of the study. Both receive CRT. Randomised to receive either SCIT or control group. Cognitive Remediation Therapy (CRT) ‐ designed to address cognitive deficits by utilising educational software to create a rich learning environment that is intrinsically motivating and rewarding. The treatment will be provided over 10 weeks, 2 times per week. The intervention involves game‐based cognitive training with bridging provided in session by trained mental health clinicians (eg. psychologist, occupational therapist, nurse, social worker). The game‐based cognitive training is designed specifically for the study as per processes designed by Medalia, Revheim, and Herlands, 2009. The package is made up of freely available games. Attendance to the program will be monitored. Social cognition and Interaction Training (SCIT) ‐ is a manualised treatment designed to address social cognitive deficits. It consists of 20 one‐hour sessions over 10 weeks. Training is run in small groups of three to six people using a manual‐driven suite of activities. The training approach of SCIT is such that participants receive repeated exposure and practice of the skills that underlie complex mental‐state reasoning abilities. Activities centre on social situations with a focus on making inferences and predictions about the characters’ thoughts, feelings, and behaviours. The group is facilitated by 2 trained mental health clinicians and attendance is monitored for intervention adherence. CONDITION: Cognitive deficits Social deficits PRIMARY OUTCOME: Proportion of participants with an improvement in functioning compared to baseline as indicated by the Activity and Participation Questionnaire and the Social and Occupational Functioning Assessment Scale (SOFAS) SECONDARY OUTCOME: Changes in cognition as measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Trail Making Test A & B and the Wechsler Abbreviated Scale of Intelligence II. Changes in Quality of life as measured by the Assessment of Quality of Life (AQoL‐8D) Changes in social cognitive functioning as measured by the Hinting Task, Penn Emotion Recognition Task (ER‐40) and the Ambiguous Intentions Hostility Questionnaire (AIHW) INCLUSION CRITERIA: 1. A diagnosis of a severe mental illness and neurocognitive or social cognitive deficits) 2. Are aged 17 – 25 years 3. Able to provide consent (and parent/guardian if required) 4. Have reasonable English skills.