Transcript EBP Schizophrenia Group Presx

Schizophrenia
Do you hear what I hear?
How does it present?
 A chronic, severe, an disabling brain disorder
 Hear voices
 Paranoia
 People are reading their mind
 Controlling their thoughts
 Plotting to harm them
What causes schizophrenia?
 Genes and environment
 1% of population has schizophrenia
 Occurs in 10% with a 1st degree relative
 One or more genes…?
 Imbalance of chemicals of the brain
 Don’t know all gene combinations that cause it
 Fluid filled ventricles and less gray matter (consistency)
Schizophrenia Part 1
 Homeless
 Had a family
 Had a career
 Had friends
 Doesn’t want “help”
 Does he “need” it…?
 https://youtu.be/rCbf-pKtkhU
Jade
Effectiveness of Occupational Goal
Intervention (OGI)
 Focused on executive function (EF)
 Remedial or process-oriented
 Direct cognitive retraining
 Targets underlying mechanisms that may be causing issue
 Use assets for success
Method
 18 participants
 Diagnosed w/ schizophrenia from DSM IV
 Ages 22-38
 Excluded if any other neurological issues
 Excluded for addiction or severe cognitive impairment
 Randomly assigned to 1 of 3 groups
 Occupational Goal Intervention (OGI)
 Frontal/ Executive Program (FEP)
 Activity Training Approach (ATA) control group
Effective Measures/ Evaluations
 Standard Progressive Matrices (Raven’s test)
 Wisconsin Card Sorting Test (WCST)
 The Wechsler Adult Intelligence Scale (WAIS – III)
 Behavioral Assessment of the Dysexecutive Syndrome (BADS)
 Executive Functions Performance Test (EFPT)
 Routine Task Inventory – Expanded (RTI – E)
 Activity Card Sort (ACS)
 Reintegration to Normal Living Index (RNL)
Intervention
 Occupational Goals Intervention (OGI)
 Strategy learning using ADL’s and IADL’s
 Individual choice
 Food prep, $ management, reading writing and comp. lit.
 Frontal/ Executive Program (FEP)
 3 modules: cog. Shift, working mem., planning deficits
 Paper and pencil w/ some construction activities
 Activity Training Approach (ATA)
 Activity specific routines
 Taught specific tasks with habituation the goal
Procedure
 Tested at three points in program
 18 sessions each
 2-3 sessions/ wk at 1-1.5 hour/ session
 6-8 weeks with a follow up 6 months later
Results
 All groups improved EF measures
 Highest were among the OGI group
 Followed by FEP group, then ATA (control)
 Using remedial or strategy learning approach is profitable
 OGI improved performance in daily functions
 Both the OGI and FEP groups had greater improvements that
the control group
 All achievements were sustained 6 months later
Kristen
References
 National Institute of Mental Health (HIM). taken from:
http://www.nimh.nih.gov/health/topics/schizophrenia/index.s
html
 Katz, N., Keren, N. (2011). Effectivness of occupational goal
intervention for clients with schizophrenia. American Journal
of Occupational Therapy, 65, 287 -296. doi:
10.5014/ajot.2011.001347