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Cognitive training and supported employment for persons with severe mental illness: one-year results from a randomized controlled trial.

This study examined the effectiveness of cognitive training (the Thinking Skills for Work Program) for improving competitive employment outcomes in persons with severe mental illness who have a history of job failure. Forty-four clients receiving services at 2 inner-city community mental health agencies were randomly assigned (within each site) to receive either cognitive training and supported employment (CT + SE) or supported employment only (SE Only). Retention in the CT + SE program was high (91%). Baseline to 3-month assessments showed significantly greater improvements in neurocognitive functioning, depression, and autistic preoccupation on the Positive and Negative Syndrome Scale for the CT + SE set compared to the SE Only group. Employment outcomes over 1 year showed that clients who received CT + SE were significantly more likely to work (69.6 versus 4.8%, respectively), worked more jobs, worked more hours, and earned more wages than clients with SE Only. The findings provide support for the feasibility of implementing the Thinking Skills for Work Program in the context of supported employment and its beneficial effects on cognitive functioning and competitive employment in persons with severe mental illness.

Adult↗

Cognitive remediation and vocational rehabilitation for schizophrenia.

Cognitive deficits are a central and debilitating aspect of schizophrenia and other major mental illnesses. Although they are largely refractory to pharmacotherapy, multiple studies have now shown that large and lasting improvements in cognition can result from behavioral interventions. We will review our work over the past 10 years demonstrating that cognitive remediation treatment together with work therapy or supported employment can lead to large, lasting, and clinically relevant improvements in cognition and work functioning. While we will make some references to the work of others in these same areas, this is not a general review of these areas of research. Instead, the goal is to provide the rationale for the progression of our studies, describe the methods, and summarize the results, so that readers may understand, critique, and improve upon what we have done.

Cognition Disorders↗

Cultural barriers.

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Cultural Diversity↗

Recruitment and retention program for minority and disadvantaged students.

Attracting ethnic minority and disadvantaged students to health careers and facilitating their successful completion of training program requirements have been major activities of the University of Colorado Medical Center since 1969. As a result of extensive college campus recruitment efforts, high school and college level preprofessional programs, and the participation of ethnic minority faculty members in the medical school admissions process, the number of applicants to the medical school increased from 45 in 1971 to 265 in 1977. Concurrently, medical school matriculants increased from 12 in 1971 to 24 in 1977, with a maximum of 30 in 1975. However, significantly fewer minority students have shown interest in nursing, dentistry, or allied health professions careers. Because of support programs for matriculants (including preadmission and postadmissions personal, academic, study skills, and test-taking counseling and a prefreshman year summer orientation course), 71 percent of the minority students entering medical school in 1971-73 have received the M.D. degree.

Colorado↗

Attitudes toward the medical career: findings from the Alpha Omega Alpha survey of college and university undergraduates.

In 1989, when the number of applicants to medical schools had been comparatively low for several years, trustees of Alpha Omega Alpha commissioned Louis Harris and Associates to conduct a survey to investigate the attitudes that led college undergraduates toward or away from choosing medical careers. A total of 1,780 college students and 93 premedical advisors from 100 U.S. schools were interviewed in early 1990. The students were in three groups: a national cross-section of 1,003 undergraduates who were not applicants to medical school; 500 medical school applicants for the entering class of 1990; and 277 students who had taken the Medical College Admission Test (MCAT), were qualified for admission, but had not applied. The authors acknowledge that the reasons that the medical school applicant pool was so low in the late 1980s and has fluctuated so widely in the last two decades are only partly understood. The data gathered indicate that job satisfaction was an extremely important factor in career choice for high percentages of students in all the groups surveyed; that 77% of all the students had never seriously considered applying to medical school; and that 70% saw no attraction in becoming a physician. Data on other problems that many of the students saw in medical education and the practice of medicine are reviewed, the role of premedical advisors is examined, and the advisors' views on what makes a promising applicant are described. Regarding the students who took the MCAT exam but did not apply to medical school, 81% indicated that they eventually planned to or were likely to apply.(ABSTRACT TRUNCATED AT 250 WORDS)

Attitude↗