Cognitive Skills Training to Improve Vocational Outcome in Homeless Youth

描述(由申请者提供)：最近的荟萃分析结果表明，无家可归的青年表现出严重的认知障碍和职业成就下降。认知障碍限制了就业准备培训等现有职业服务的益处，从而导致长期失业和长期无家可归。目前，经验数据支持使用治疗来针对认知，并将其与其他社区服务相结合，为无家可归的成年人提供服务。在一系列成人人口中实施的认知补救在认知改善和获得社区运作目标方面产生了积极的结果。然而，到目前为止，这种认知干预还没有应用于无家可归的青年。认知收获为学习提供了一个必要的平台，以支持社区就业所需技能的发展。因此，在这一关键的发展时期采取成功的干预措施，对于制止累积功能性残疾和长期无家可归的潜在有害轨迹至关重要。本研究的目的是进行认知矫正的对照研究，为流浪青年采用基于经验的认知干预以帮助他们实现职业目标提供可行性数据。最终目的是使年轻人的认知功能得到改善，并获得更好的功能结果，包括维持独立生活的工作。这项研究的结果将为一项关于在无家可归的青年中进行认知补救以改善认知和职业结果的有效性的更大规模的试验提供参考。这项拟议的研究将涉及圣约人之家通行权项目的90名参与者，年龄在18岁至21岁之间。圣约人之家是一家社区机构，为失业和受教育不足的无家可归青年提供就业培训、补救性教育、住房、医疗保健和咨询。假设是，与接受计算机化工作技能培训的积极控制组的人相比，接受认知补救的个人将在神经认知的近距离测量中表现出更大的认知益处，并证明更多的工作小时数定义的更好的职业结果。这项研究将解决在对无家可归人口使用综合心理社会干预方面的服务差距，作为对无家可归青年认知补救的第一次调查。

DESCRIPTION (provided by applicant): Recent meta-analytic findings demonstrate that homeless youth evidence significant cognitive impairment and decremented vocational achievements. Cognitive impairment limits the benefit from available vocational services such as job readiness training, thereby contributing to chronic unemployment and enduring homelessness. At present, empirical data support the use of treatments to target cognition that are integrated with other community services for homeless adults. Cognitive remediation implemented in a range of adult populations has yielded positive outcomes with respect to cognitive improvement and acquisition of goals for community functioning. However, as of yet, such cognitive interventions have not been employed in homeless youth. Cognitive gains provide a necessary platform for learning to support the development of skills needed for employment in the community. Successful intervention at this critical developmental period is thus crucial to halt a potentially detrimental trajectory of accumulating functional disability and enduring homelessness. The aim of this research is to conduct a controlled study of cognitive remediation, to provide feasibility data on adapting an established empirically-based cognitive intervention for homeless youth to help them attain vocational goals. The ultimate purpose is that youth will improve in cognitive functioning and have better functional outcomes including jobs to sustain independent living. The results of this study will inform a larger trial on the efficacy of cognitive remediation in homeless youth to improve cognition and vocational outcomes. The proposed study will involve 90 participants, ages 18 to 21, at the Rights of Passage program at Covenant House, a community agency that offers job training, remedial education, housing, medical care, and counseling to unemployed and under-educated homeless youth. Hypotheses are that, compared to those in an active control group receiving computerized work-skills training, individuals who receive cognitive remediation will show greater cognitive benefits on proximal measures of neurocognition and evidence better vocational outcome as defined by greater number of hours worked. This study will address the service gap in the use of integrated psychosocial interventions for homeless populations as the first investigation of cognitive remediation in homeless youth.