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Background
Seven Counties Services, one of Kentucky’s largest safety net providers of behavioral health services, recently completed a 12-month pilot that focused on using cognitive training provided by Learning Rx at its Recovery Zone day program. LearningRx is a cognitive training program that is used primarily for children with learning difficulties, but can also benefit adult populations, such as those with traumatic brain injury and seniors. The intent of this pilot was to determine the potential of LearningRx as an effective cognitive training program for people with schizophrenia. The study focused on programming for nine individuals diagnosed with schizophrenia.
The LearningRx approach to cognitive training is based on brain research that has largely occurred over the last decade. Studies demonstrate that our brains develop throughout our lives and that they are constantly being modified. Intensive training and practice can stimulate brain development in targeted areas. This is known as neuroplasticity. LearningRx has leveraged these findings in brain development to create a program that focuses on developing those cognitive, brain-based skills that allow individuals to take in and use sensory information more efficiently.
Utilizing cognitive training programs for individuals with schizophrenia is not a new concept. The National Institute of Mental Health funded a study that showed that cognitive training was effective for this population. It is believed that this training improves processing speed, attention, memory, problem solving, and social cognition. Functional disabilities of individuals with schizophrenia are strongly related to impairments in these mental processes.
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A participant in the pilot study |
The Pilot Study
Studies at the University of Pittsburgh Medical Center’s Western Psychiatric Institute and Clinic and other locations have been performed that include cognitive training along with a weekly group psychotherapy session. In these past studies, cognitive training has been administered through a computer program for 1 hour per week, along with a 1.5 hour group session and another 1 hour coaching session.
For the Seven Counties’ study, each group member participated in one-on-one LearningRx exercises for 1 hour per week, as well as another hour of computer-based Learning Rx exercises. At the end of each week, a group therapy session was conducted by a therapist.
Barriers
In conducting this pilot, a primary concern was the availability of the participating individuals. The nine participants were selected based on their diagnosis, as well as how often they attended the Recovery Zone. Even so, many of these individuals still had inconsistent schedules and found it difficult to connect with their trainer for LearningRx for regular weekly sessions. Additionally, LearningRx compares cognitive training to physical training in that there needs to be a basic desire to participate and motivation for improvement. Some small incentives were included, but several participants lacked enthusiasm about the program.
Results
Prior to beginning the LearningRx pilot, each of the nine participants was asked to complete the Woodcock-Johnson III assessment for cognitive abilities. Approximately one year later, the assessment was administered again to compare results. While these results were not profound, they did move the needle. The following chart summarizes the percentile placement and percentage gain from each participant.
Student |
Pre- Percentile Rank |
Post- Percentile Rank |
% change |
Female, 50 |
17.2 |
25.2 |
46.5% |
Female, 71 |
27.7 |
36.4 |
31.4% |
Female, 40 |
16.1 |
24.5 |
52.2% |
Male, 44 |
20.4 |
30.1 |
47.5% |
Female, 48 |
3.2 |
7.1 |
121.9% |
Overall Average |
16.92 |
24.66 |
45.7% |
Additionally, several anecdotal observations were made about two students – Female, 50, and Male, 44. Staff noticed that these two individuals displayed better social skills and were more assertive in their conversations and daily lives. Female, 50, recently obtained her driver’s permit and hopes to earn her driver’s license in the near future.
About Seven Counties Services
Seven Counties Services provides behavioral health, developmental disability, and substance abuse services for Louisville and the surrounding counties. The organization was formed in 1978 and currently serves approximately 32,000 individuals per year.