INT - Integrated Neurocognitive Therapy
INT corresponds to a further development of the cognitive part of the well-known Integrated Psychological Therapy (IPT, included in this homepage), which was also developed in our lab. INT aims to improve all 11 schizophrenia-related neurocognitive and social-cognitive functional areas initially defined by the NMIH-MATRICS initiative.The comprehensive, integrative group therapy program is divided into 4 modules, starting with basal cognitive functions and ending with complex functional areas. Finally, tasks on stress management and emotion regulation are included.
Each of the 11 functional areas follows the same didactic sequence: including CBTp and psychoeducational techniques, 1) an education on the target function takes place, including the individual experience with this area, then 2) individual coping strategies are defined (compensation approach), which 3) are repeatedly tried out and practiced in partly PC-supported exercises (restitution approach), and finally 4) are also used in in-vivo exercises to support the transfer into everyday life.
The uniqueness of INT lies in the fact that a) this integrative approach is still the only one to date that treats all 11 neuro- and social-cognitive NIMH-MATRICS dimensions within a comprehensive therapy concept, b) during the therapy process, the patient's self and everyday life are consistently taken into account - or in other words, the patient's everyday experience and behavior is brought into the therapy room, and c) proximal and distal therapy effects can be observed far beyond the therapy and have been proven in empirical studies. In addition to neurocognitive and social-cognitive improvements (proximal outcome, which corresponds to the immediate treatment goal), these studies also demonstrate the evidence for INT in the distal outcome, which does not correspond to the primary treatment goal: a reduction in the primary negative symptoms that are difficult to treat and relapse prevention. A recent study also shows a reduction in gesture deficits when INT is used in combination with repetitive transcranial magnetic stimulation (rTMS).
Is INT right for me?
INT promotes neurocognitive functions (e.g. attention, speed of processing, visual and verbal memory, working memory, problem solving) and social cognitive functions (e.g. emotion perception, social perception, theory of mind, attribution, social schema) in the patient's everyday coping with simple, easy-to-understand group exercises and some PC exercises (neurocognitive part). Participants receive various information and worksheets that they can take home with them at the end of the therapy so that they can refer back to them at any time. The highly varied and individualized therapy materials, the structured approach based on errorless-learning principles and the consistent promotion and use of group dynamics (e.g. “we are a team”) promote the intrinsic motivation of the participants. The therapy materials are easy to use for both therapists and participants and generally result in a low group drop-out rate of patient (<10%). INT groups take place with 4-8 patients and are led by 2 well-trained therapists. Usually, 1-2 sessions are offered per week, each session lasts 90 minutes. The duration of therapy varies between 15 and a good 30 sessions, depending on the level of performance. Until now, INT has mainly been carried out with outpatients, but a recent study shows excellent results for inpatients too. Some experts also include patients with other disorders (e.g. affective disorders, borderline). In these mixed groups, all patients exhibit cognitive deficits, among other deficits and symptoms.
What does an INT session involve?
During a brief intake interview, newly assigned patients receive information on the content, aims and procedure of the group. In addition, fears and anxieties about group participation are addressed and attempts are made to reduce them (group rules such as no compulsion to speak, mistakes are allowed, confidentiality and mutual support). At the beginning of each session, care is taken to ensure that all participants can also bring private concerns into the group, which is greatly appreciated. At the beginning, the therapists structure the promoted interactions more strongly and always pay great attention to the motivation of the participants in group exercises, PC-exercises, or in real life sessions. Among other things, the permanent inclusion of the patients' everyday experiences also contributes to this.
The main part of the program consists of cooperative individual work on each of the 11 focused cognitive functional areas with corresponding, highly varied exercises, which are described in the therapy manual. It is important that the therapists take the patient's needs into account as far as possible, also with regard to the content of the therapy. Each cognitive function is usually worked on during 2-4 consecutive sessions, which are linked by the therapists with so-called flashes at the beginning and end of each session. Against the background of INT's therapeutic rationale of viewing patients as reasonable, equal fellow human beings with functional strengths and weaknesses, regardless of their symptoms, they are naturally given the right to receive information at any time about which exercises are used for which purpose in which part of the therapy program and to test out the individualized coping strategies they have learned in the group setting. This maximum possible transparency also makes it easier for new members to join the group.
What are the qualifications of INT therapists?
As a rule, at least the main INT therapist has completed postgraduate cognitive-behavioral therapy training for psychologists or psychiatrists. In addition, both therapists have completed practical INT training courses of 2-3 days, where they have learned the didactics and INT technology from experienced instructors. Supervision for therapists by the founders of INT or experienced instructors is often offered afterwards.
How can I provide INT to my clients?
The INT manual has been translated into 3 languages. The trained INT therapists use this manual as a guide when leading groups. Information to professional referrers and interested clients has so far generally been organized regionally through information flyers and published contact options. Further information is available from the two founders of INT by e-mail or in the detailed manual.
Explorez les recherches autour de ce programme
Does Integrated Neurocognitive Therapy (INT) reduce severe negative symptoms in schizophrenia outpatients?
Mueller, D. R., Khalesi, Z., Benzing, V., Castiglione, C. I., & Roder, V. (2017).
One-Year randomized controlled trial and follow-up of Integrated Neurocognitive Therapy for schizophrenia outpatients.
Mueller, D. R., Schmidt, S. J. & Roder. V. (2015)
À propos du Cognitive Remediation Experts Workshop (CREW)
Nous sommes un réseau international de professionnels dédiés à l'avancement de la remédiation cognitive. Notre expertise porte sur la remédiation cognitive pour les troubles du spectre de la schizophrénie et d'autres troubles mentaux graves. Par la recherche, la formation et la collaboration, nous visons à améliorer la qualité des thérapies de remédiation cognitive et à les rendre accessibles.