The present proposal responds to a program announcement from the National Institute of Mental Health (NIMH) for exploratory/development grants for mental health intervention research, and focuses on work rehabilitation. Chronic unemployment poses a significant problem to the overall health and welfare of persons with severe and persistent mental illness (SPMI). Even in the most successful supported employment programs, approximately 50 percent of SPMI clients have unsatisfactory job terminations within the first six months of employment. One of the factors contributing to unsatisfactory job termination is poor work performance. The present project will attempt to address this need by developing a job-training manual to be used by job coaches and other persons working with SPMI individuals to assist them in teaching their clients how to perform the duties of their jobs more proficiently. The training intervention to be developed in the manual is based on principles of errorless learning and takes into consideration the neurocognitive processing limitations of many persons with SPMI. In errorless learning, training begins with the simplest, most basic task components where there is a high probability of performance success and proceeds step-wise through a series of graduated training exercises. Errors are minimized by establishing mastery at each step and very gradually introducing more complex components of the to-be-learned task. After completion of the manual, a pilot study will be conducted to test the utility of the training manual as used by job coaches in the community. A sample of forty schizophrenia and schizoaffective disorder subjects with identified difficulties in work performance will be included in the pilot study. Subjects will be randomly assigned to one of two groups: enhanced support vs. errorless learning. The enhanced support group will receive the same type of job training that they received when they began the job, but will receive additional training to match the time involvement of job coaches in the errorless learning group. Measures of work performance, job tenure, time missed from work, job satisfaction, self-esteem, and job stress will be administered immediately after training and two-weeks, four-weeks, three-months, six-months, and one-year after training. If successful, the manual and training intervention employed in the pilot study will be used in a larger, community-based controlled study. Based on previous data collected in the laboratory and a simulated work environment, the errorless method has promise for helping SPMI clients improve their work performance and perhaps, improve overall employment and personal well being.
| Kern, Robert S; Liberman, Robert P; Becker, Deborah R et al. (2009) Errorless learning for training individuals with schizophrenia at a community mental health setting providing work experience. Schizophr Bull 35:807-15 |
| Velligan, Dawn I; Kern, Robert S; Gold, James M (2006) Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies. Schizophr Bull 32:474-85 |
