A Dismantling Study of Cognitive Rehabilitation for Supported Employment



NIMH R01 Grant


5/17/12 – 4/30/17

Contact: Susan McGurk


Impaired cognitive functioning in consumers with severe mental illness (SMI) is an obstacle to benefiting from vocational rehabilitation programs, including supported employment, the most empirically supported vocational rehabilitation model. The Thinking Skills for Work (TSW) program is a cognitive remediation program in which consumers are engaged in computer-based cognitive exercises and learn coping strategies for managing cognitive difficulties related to looking for work or maintaining competitive employment. The TSW program is provided in the context of supported employment. Several previous randomized controlled trials have shown that consumers who receive the TSW program in addition to their usual vocational rehabilitation services improve significantly more in cognitive functioning and have significantly better work outcomes compared to consumers who continue to receive vocational services. However, it is unknown what elements of the TSW program impart demonstrated cognitive and work benefits and, whether a more streamlined version of TSW would be equally effective, or, whether some consumers require the full TSW program whereas others would benefit equally from the briefer version of the program. This “dismantling” study will evaluate whether providing computer cognitive exercises in addition to teaching coping strategies is critical to improving cognitive and employment outcomes in the TSW program, or whether a streamlined version of the program that only teaches coping strategies is equally effective.

This study will address this question by comparing the full version of the TSW program (including computer cognitive practice and teaching coping strategies) to a briefer version of the program that focuses only on teaching coping strategies (called the Cognitive Skills for Work, or CSW, program). A total of 244 unemployed consumers with cognitive impairment who are receiving supported employment at either the Mental Health Center of Greater Manchester in Manchester, NH or Thresholds Inc. in Chicago, IL, will be randomly assigned to receive either the TSW or CSW program. All consumers will continue to receive supported employment services throughout the 2-year study period. Work will be tracked on a weekly basis, with cognitive and clinical assessments conducted at baseline, 6 months following assignment to the TSW or CSW program, and 1- and 2-years following group assignment. The results of this study will inform the use of cognitive services for consumers with SMI seeking to improve their work prospects.


BU Center for Psychiatric Rehabilitation Staff Role
Susan R. McGurk, Ph.D. Principal Investigator
Kim T. Meuser, Ph.D. Co-Principal Investigator
Philippe Bloch, M.Ed. Project Coordinator
Dartmouth Medical School Staff Role
Deborah R. Becker, M.Ed. Co-Investigator
Gary R.Bond Co-Investigator
Robert E. Drake, M.D., Ph.D. Co-Investigator
Gregory J. McHugo, Ph.D. Co-Investigator
Haiyi Xie, Ph.D. Co-Investigator
Rosemarie Wolfe, M.S. Data Manager
Mental Health Center of Greater Manchester, NH Staff Role
Harry Cunningham, M.S.W. Site PI
Sue Guarino, B.A. Site Project Coordinator
Edward Bailey, M.A. Supported Employment Director
Heather Gagnon, B.A. Cognitive Specialist
Jason Welch, M.A. Evaluator
Thresholds Inc., Chicago Staff Role
Kristin Davis, Ph.D. Site PI
Susan Kaiser, M.A. Site Project Coordinator
Ginnie Fraser, M.A. Supported Employment Director
Anabel Ruiz, B.A. Cognitive Specialist
Vanessa Vorhies, M.A. Evaluator
Sarah Todd, B.A. Evaluator
Izabela Krzos, B.A. Evaluator


No documents are available at this time. Please use the project contact for specific inquiries.


Inquiries related to the project should be addressed to:

Susan McGurk

Boston University, Center for Psychiatric Rehabilitation
940 Commonwealth Avenue West, 2nd Floor
Boston, MA 02215