1. Schizophrenia
Do you hear what I hear?

2. How does it present? A chronic, severe, an disabling brain disorder
Hear voices
Paranoia
People are reading their mind
Controlling their thoughts
Plotting to harm them

3. What causes schizophrenia?
Genes and environment
1% of population has schizophrenia
Occurs in 10% with a 1st degree relative
One or more genes…?
Imbalance of chemicals of the brain
Don’t know all gene combinations that cause it
Fluid filled ventricles and less gray matter (consistency)
1st degree relative = mom, dad, brother, sister. If a twin has schizophrenia, the other is 40-65% likely to get it. Risk goes up if a cousin or 2nd degree relative is diagnosed.

4. Schizophrenia Part 1 Homeless Had a family Had a career Had friends
Doesn’t want “help”
Does he “need” it…?

5. Jade

6. Effectiveness of Occupational Goal Intervention (OGI)
Focused on executive function (EF)
Remedial or process-oriented
Direct cognitive retraining
Targets underlying mechanisms that may be causing issue
Use assets for success
EF are considered essential elements in non-routine situations and in performance of complicated or new tasks that require coordination among subporcesses to achieve a specific goal.

7. Method 18 participants Diagnosed w/ schizophrenia from DSM IV
Ages 22-38
Excluded if any other neurological issues
Excluded for addiction or severe cognitive impairment
Randomly assigned to 1 of 3 groups
Occupational Goal Intervention (OGI)
Frontal/ Executive Program (FEP)
Activity Training Approach (ATA) control group

8. Effective Measures/ Evaluations
Standard Progressive Matrices (Raven’s test)
Wisconsin Card Sorting Test (WCST)
The Wechsler Adult Intelligence Scale (WAIS – III)
Behavioral Assessment of the Dysexecutive Syndrome (BADS)
Executive Functions Performance Test (EFPT)
Routine Task Inventory – Expanded (RTI – E)
Activity Card Sort (ACS)
Reintegration to Normal Living Index (RNL)

9. Intervention Occupational Goals Intervention (OGI)
Strategy learning using ADL’s and IADL’s
Individual choice
Food prep, $ management, reading writing and comp. lit.
Frontal/ Executive Program (FEP)
3 modules: cog. Shift, working mem., planning deficits
Paper and pencil w/ some construction activities
Activity Training Approach (ATA)
Activity specific routines
Taught specific tasks with habituation the goal
Computer literacy specifically for information seeking.

11. Procedure Tested at three points in program 18 sessions each
2-3 sessions/ wk at hour/ session
6-8 weeks with a follow up 6 months later

12. Results All groups improved EF measures
Highest were among the OGI group
Followed by FEP group, then ATA (control)
Using remedial or strategy learning approach is profitable
OGI improved performance in daily functions
Both the OGI and FEP groups had greater improvements that the control group
All achievements were sustained 6 months later
OGI – the importance of transferring and generalizing from treatment to real life is strongly acknowledged by researchers and clinicians in rehab and OT. Contribution to OT is the inclusion of wide range of activity and participation outcome versus other studies focusing on social skills, meal prep, work, etc.

13. Kristen

15. References
National Institute of Mental Health (HIM). taken from: html
Katz, N., Keren, N. (2011). Effectivness of occupational goal intervention for clients with schizophrenia. American Journal of Occupational Therapy, 65, doi: /ajot