The Schizophrenia Rehabilitation Program (SRP) at the Institute of Living/Hartford Hospital is the 2018 recipient of the Program of the Year Award from the Association of Ambulatory Behavioral Health. This award is given annually to a program demonstrating outstanding advocacy for partial hospitalization and intensive outpatient programs, innovation in program, or excellent patient outcomes.
SRP is a three-day per week intensive outpatient program that offers comprehensive, long-term psychiatric rehabilitation services to adults ages 21 to 55, with schizophrenia spectrum disorders who have functional community goals such as school, work or independent living. Treatment includes computerized cognitive rehabilitation, individual psychotherapy, group-based therapies and skill building, medication management, physical exercise, educational tutoring, vocational counseling, transitional work therapy, case management, and family meetings. The Institute of Living Work Skills Training Program and Easter Seals are integrated collaborative partners with SRP to provide vocational and educational counseling and support for clients pursuing these community goals.
SRP is a contemporary psychosocial treatment program incorporating cutting-edge therapies that are “hot off the press.” Empirical research is conducted by staff under the supervision of Dr. Jimmy Choi to inform practices that meet the highest standards of evidence-based care, thus creating a modern program that is always up to date with the latest scientific findings. At this time, SRP is the only psychiatric program in the nation to use the following innovations:
SRP promotes the synergistic value of combining physical exercise and cognitive rehabilitation using virtual-reality technology called “exergaming.” Exergaming is interactive exercise equipment connected to a computer and monitor so the patient is engaged in a mentally stimulating game while exercising. For example, while pedaling on a specialized exergaming stationary bike, they “race through the countryside” while using a virtual reality headset.
RP’s neurofeedback cognitive rehabilitation is a program that uses a psychophysiological measure of task engagement and cognitive resource allocation (pupil dilation) to gauge the difficulty and stimulation of training exercises, and automatically adjusts these exercises to hit the “sweet spot” so the training is challenging and stimulating but not so difficulty or overwhelming that clients disengage. This training is delivered on tablets, and it is the first ever neurofeedback training developed for psychosis.
Along these lines, SRP incorporates the exergaming and neurofeedback cognitive rehabilitation into an overall treatment algorithm using decisional informatics. Decisional informatics is SRP’s cyber system that informs real-time clinical decision-making that allows the treatment to evolve as the client progresses through various stages of recovery. Performance data from exergaming and cognitive rehabilitation are automatically entered into a database, and a computerized formula based on current scientific literature then outputs a suggested course of treatment. The staff considers this information in reformulating the client’s cognitive treatment for the following week. For example, the computerized formula will suggest that a client requires additional lessons in a certain memory skill instead of moving to the next lesson. Staff will then create a schedule in the cognitive skills group that allows the client to work on the specific memory skill until ready to advance. This is a tailored and highly personalized client-centered approach.
