Cognitive Skills Training to Improve Vocational Outcome in Homeless Youth

描述（由申请人提供）：最近的荟萃分析结果表明，无家可归的年轻人有显著的认知障碍和职业成就下降。认知障碍限制了从就业准备培训等现有职业服务中获益，从而导致长期失业和长期无家可归。目前，经验数据支持对无家可归的成年人使用与其他社区服务相结合的治疗来瞄准认知。在一系列成年人群中实施的认知补救措施在认知改善和社区功能目标的获得方面取得了积极的成果。然而，到目前为止，这种认知干预还没有被用于无家可归的年轻人。认知增益为学习提供了必要的平台，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进行成功的干预，对于阻止功能残疾积累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修复的对照研究，以提供可行性数据，以适应已建立的基于经验的认知干预，以帮助无家可归的青少年实现职业目标。最终目的是提高年轻人的认知功能，并有更好的功能结果，包括维持独立生活的工作。本研究的结果将为更大规模的试验提供信息，以了解认知补救对无家可归青年的有效性，以改善认知和职业结果。这项拟议的研究将涉及90名年龄在18至21岁之间的参与者，他们来自圣约之家（Covenant House）的“通行权”项目。圣约之家是一家社区机构，为失业和未受教育的无家可归青年提供职业培训、补救教育、住房、医疗保健和咨询服务。假设是，与那些接受计算机化工作技能培训的积极对照组相比，接受认知补救的个体在神经认知的近端测量中表现出更大的认知益处，并且根据更多的工作时间来确定更好的职业结果。本研究将作为对无家可归青年认知修复的首次调查，解决在无家可归人群中使用综合社会心理干预的服务差距。

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. PUBLIC HEALTH RELEVANCE: Many young people who are homeless have cognitive deficits which impede their ability to secure and maintain employment. This study looks to see if targeting cognitive deficits can improve cognition and vocational outcome.