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This study aims to test the hypothesis that addition of Individual Placement and Support (IPS) and/or Cognitive Remediation Therapy (CRT) in addition to treatment as usual in patients with early psychosis will be feasible and acceptable in patients with early schizophrenia.
This is an assessor blind, randomised controlled trial, employing a factorial design. This trial aims to assess the feasibility of IPS, CRT or their combination as an add on to treatment as usual. Patients with early schizophrenia spectrum disorder will be recruited from major psychiatric units in Pakistan. Treatment as usual (TAU) will comprise of patient's current antipsychotic medication as prescribed by their responsible clinician. Patients will be randomised into IPS, CRT, their combination or TAU, according to the 2x2 factorial schedule in the table. A total of 30 participants will be recruited in each cell, giving a total of 120 participants.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Individual Placement and Support (IPS) | Experimental | IPS is a vocational support program to facilitate return to employment in individuals with severe and enduring mental illnesses. |
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| Cognitive Remediation Therapy (CRT) | Experimental | CRT will be delivered twice weekly individual computerised CRT with therapist input. This therapy will be delivered by a CRT trained assistant psychologist. |
|
| IPS and CRT | Experimental | A combination of IPS and CRT will be provided to participants in this arm. |
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| Treatment as usual | No Intervention | Continued input as normal with treating psychiatrist. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Individual Placement and Support | Behavioral | Individual Placement and Support is a vocational support program that was developed in the USA, to facilitate return to employment in individuals with severe and enduring mental illnesses. |
| Measure | Description | Time Frame |
|---|---|---|
| Feasibility of undertaking a trial of the intervention, as determined by: Recruitment and attrition rates | Recruitment and attrition rates: This will be determined using recruitment and attrition rates into the trial | 6 month post intervention |
| Acceptability of the intervention, as determined by: number of sessions attended | Therapy logs: therapy logs with number of sessions attended | 6 months post intervention |
| Client Satisfaction Questionnaire (CSQ) | Participants' satisfaction will be measured using CSQ-8. The scale consists of 8 items score range from 8 to 32, with higher values indicating higher satisfaction. | 6 month post intervention |
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Inclusion Criteria:
Exclusion Criteria:
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Anonymised data once analysed and published will be available on reasonable request.
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| Cognitive Remediation Therapy | Behavioral | This is an evidence based intervention that aims to improve cognitive functioning. |
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| ID | Term |
|---|---|
| D012559 | Schizophrenia |
| D011618 | Psychotic Disorders |
| ID | Term |
|---|---|
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D001523 | Mental Disorders |
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| ID | Term |
|---|---|
| D010166 | Palliative Care |
| ID | Term |
|---|---|
| D005791 | Patient Care |
| D013812 | Therapeutics |
| D006296 | Health Services |
| D005159 | Health Care Facilities Workforce and Services |
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