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CAT Intro Presentation UT Health San Antonio, Department of Psychiatry, Division of Community Recovery, Research and Training. Overview. Symptom and cognitive challenges in serious mental illness How cognitive problems relate to community functioning

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Overview

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  1. CAT Intro PresentationUT Health San Antonio, Department of Psychiatry,Division of Community Recovery, Research and Training

  2. Overview • Symptom and cognitive challenges in serious mental illness • How cognitive problems relate to community functioning • How Cognitive Adaptation Training (CAT) can make a difference • CAT Training • International Center of Excellence • Motivational Interviewing and CAT

  3. Serious Mental Illness: Challenges related to outcome • Behavioral Challenges • Amotivation • Decreased activity • Social withdrawal • Substance Use • Insomnia • Psychosis • Delusions • Hallucinations • Disorganized speech/behavior • Community Functioning/Behavior • Work/School • Interpersonal relationships • Self-care/ADLs • Medication Adherence • Cognitive Challenges • Attention • Memory • Executive functions • Psychomotor Speed • Mood and Emotional Challenges • Depression • Mania • Anxiety

  4. Understanding Cognitive Challenges • Attention • Memory • Information-processing/psychomotor speed • Executive functions Gold JM and Harvey PD Psychiatric Clin North Am, 1993; 16: 295-312; Maples & Velligan, 2007

  5. Executive Functions • Formulate plans for goal directed behavior • Sequence behavior and thought • Maintain goal-directed-action in the face of distraction • Inhibit irrelevant or inappropriate behavior

  6. Cognitive Functioning Predicts Real-World Outcomes Executive Function Attention Memory Psychomotor Speed Daily Living Skills Social Function Work Green MF. Am J Psychiatry, 1996; 153: 321-330 Velligan et al., Schiz Res, 1997; 25: 21-31

  7. Cognitive Functioning Predicts Real-World Outcomes Executive Function Attention Memory Psychomotor Speed Daily Living Skills Social Function Work CAT Environmental Supports Green MF. Am J Psychiatry, 1996; 153: 321-330 Velligan et al., Schiz Res, 1997; 25: 21-31

  8. Cognitive Adaptation Training (CAT) • CAT is a manualized list of environmental supports such as signs, calendars, checklists and the reorganization of belongings designed to get around problems with cognitive functions and improve success in everyday behaviors • Delivered in the home environment – typically weekly • Is evidence-based • Uses a motivational strengths perspective to facilitate a person’s initiatives and independence • Treatment is based upon how the person thinks and behaves • Level of executive function • Type of behavior exhibited (apathy, disinhibition)

  9. Areas of Intervention

  10. Care of Living Environment

  11. Orientation

  12. Medication – Let’s make it easier Prompting the likelihood medication will be taken (Disinhibition) Decreasing the number of steps needed to take medication increases the likelihood that it will be taken (Apathy) Organization to address executive challenges Did I take my meds today?

  13. Promoting healthy lifestyles to address medical comorbidities

  14. Daily Checklist – Multiple Areas Brush Teeth Everyday

  15. Daily Schedule

  16. Differences Between CAT and Other Treatments or Case Management

  17. Center of Excellence • Established a Center of Excellence to offer training and sustainability of best practices for helping individuals with serious mental illness • Access for all agencies participating in the Texas Promoting Independence Initiative • Free training available to you, your agency and behavioral health affiliates • www.iceebp.com • Login into TX Promoting Independence using your work email. Let us know if you can’t login: iceebp@uthscsa.edu

  18. Resources Available to You

  19. Check out clinician's corner! Lots of templates and other important resources Resources Available to You

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