The Thinking Skills for Work Program (TSW)
The Thinking Skills for Work Program (TSW) is an evidence-based, multicomponent cognitive enhancement program designed to improve cognitive functioning and enhance competitive employment outcomes in individuals with schizophrenia and other serious mental illnesses (McGurk and Mueser, 2021). TSW is unique in having two cognitive enhancement approaches (computer cognitive training and the teaching of cognitive self-management strategies), each having a manualised, standardised curriculum, and in its comprehensive integration of cognitive enhancement with psychosocial rehabilitation for participants’ community recovery goals. This integration enhances participants’ motivation and self-confidence for their ability to improve their cognitive skills and achieve their goals. TSW includes the four techniques recommended by an international cognitive remediation expert panel for effective CR programs (Bowie et al., 2020), including: facilitation by a mental health specialist (in TSW, the facilitator is called the “cognitive specialist”), practice of cognitive exercises, teaching strategies for improving cognitive and work performance, and procedures for transferring cognitive skills to real-world functioning TSW has substantial evidence of efficacy in improving cognition and work from results of multiple national and international randomised controlled trials.
What happens in a TSW session?
For Computer Cognitive Training sessions: Participants practice cognitive skills using a standard comprehensive curriculum of 24 sessions of cognitive exercises drawn from a computer cognitive training software package, while the cognitive specialist coaches them in more effective cognitive strategies and helps link the exercises to participants’ specific work goals. The linkages to work goals enhance participants’ motivation to try hard on the cognitive exercises and to improve on cognitive tasks.
For Cognitive Self-Management Strategies sessions: The cognitive specialist meets with the participant to teach self-management strategies. The cognitive self-management aspect of TSW is based on ten educational handouts for participants that contain information about each cognitive area and how it relates to their work goals, different strategies for enhancing cognition in everyday work (and other) situations, worksheets, tips for practising the strategies, and suggestions for home assignments. Three of the topics are designed to enhance motivation and confidence for achievement of participants’ work and other goals, such as “Recognizing Your Strengths” and “Challenging Negative Thinking”; the remaining topics address optimising cognitive performance in work and other situations, such as “Reducing Memory Difficulties” and “Getting Organized for Your Job Search.”
For Job Search and Job Support Consultation sessions: The cognitive specialist, the participant, and the employment specialist meet on a monthly basis to review progress in the program, cognitive difficulties related to getting or keeping a job, and to practice self-management strategies for overcoming those challenges.
How long does a TSW session take & How long does it take to complete the TSW program?
Computer Cognitive Training and Cognitive Self-Management sessions usually last one hour. Job Search and Job Support Consultation sessions are conducted monthly and usually last 30-60 minutes.
The TSW program usually requires 6-12 months to complete, although some participants complete it faster (e.g., in 3 months). Participants sometimes get and keep a job while enrolled in TSW before completing all Computer Cognitive Training sessions. It is common for such participants to stop these training sessions while continuing to receive support and help using Cognitive Self-Management Strategies, which can be taught anywhere, including the workplace.
Who can be a cognitive specialist?
People with a master’s degree in any mental health related profession, such as a rehabilitation practitioner, social worker or psychologist can be trained to be a cognitive specialist. People with a BA level degree and 5 years’ experience working with people serious mental illnesses can also be trained to be a cognitive specialist.
What training is involved in becoming certified as a cognitive specialist to deliver TSW?
Training to be a cognitive specialist involves two steps. First, the trainee completes an online self-paced TSW course which has ten, 30-minute modules and provides the necessary background knowledge and procedures for providing the TSW program. Second, the trainee begins delivery of TSW while receiving supervision from a TSW expert. Certification is awarded when the trainee achieves satisfactory fidelity to the TSW model as determined by ratings of sessions provided by the TSW expert.
Explorez les recherches autour de ce programme
Mental health system funding of cognitive enhancement interventions for schizophrenia: Summary and update of the New York Office of Mental Health expert panel and stakeholder meeting.
McGurk, S.R., Mueser, K.T., Covell, N.H., Ciccerone, K.D., Drake, R.E., Silverstein, S.M., Medalia, A., Myers, R., Bellack, A.S., Bell, M.D., and Essock, S.M. (2012).
The feasibility of implementing cognitive remediation for work in community based psychiatric rehabilitation programs.
McGurk, S.R., Watkins, M.A, Dalton, C.M., Deutsch, H., & Mueser, K.T. (2017).
Implementation of the Thinking Skills or Work program in a psychosocial clubhouse.
McGurk, S.R., Schiano, D., Mueser, K.T., & Wolfe, R. (2010).
The effects of the combination of cognitive training and supported employment on improving clinical and working outcomes for people with schizophrenia in Japan.
Sato, S., Iwata, K., Furukawa, S., Matsuda, Y., Hatsuse, N., & Ikebuchi, E. (2014).
Cognitive remediation for vocational rehabilitation nonresponders.
McGurk, S.R., Mueser, K.T., Xie, H., Feldman, K., Shay, Y., Klein, L., & Wolfe, R. (2016).
Cognitive enhancement and illness self-management in vocational rehabilitation.
McGurk, S. R., & Mueser, K. T. (2015).
Cognitive enhancement treatment for people with mental illness who do not respond to supported employment: A randomized controlled trial.
McGurk, S.R., Mueser, K.T., Xie, H., Welsh, J., Kaiser, S., Drake, R.E., Becker, D., Bailey, E., Fraser, G., Wolfe, R., & McHugo, G.J. (2015).
Work, recovery, and comorbidity in schizophrenia.
McGurk, S.R., Mueser, K.T., DeRosa, T., & Wolfe, R. (2009).
Cognitive training for supported employment: 2–3-year outcomes of a randomized controlled trial.
McGurk, S.R., Mueser, K.T., Feldman K., Wolfe, R., & Pascaris, A. (2007).
Cognitive training and supported employment for persons with severe mental illness: One-year results from a randomized controlled trial.
McGurk, S.R., Mueser, K.T., & Pascaris, A. (2005).
Adding cognitive remediation to employment support services: A randomized controlled trial.
Burns, A. M. N., & Erickson, D. H. (2023).
Cognitive remediation in persistently mentally ill inpatients: A randomized controlled trial.
Lindenmayer, J.P., McGurk, S.R., Mueser, K.T., Khan, A., Wance, D., Hoffman, L., Wolfe, R., & Xie, H. (2008).
Explore what others have said about this programme
“I learned that having a mental illness does not mean that my world is ended.”
“I only have a GED and I don’t feel marketable and I [felt] that the sessions were helping me to find out my true hidden skills and my calling on a future job.”
”… by doing the program, I learned I can accomplish a lot in life like living a normal life in the community.”
Contact TSW
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.