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，无家可归的青年证据显着的认知障碍和职业成就递减。认知障碍限制了从现有职业服务（如就业准备培训）中获益，从而导致长期失业和长期无家可归。目前，经验数据支持使用的治疗，以有针对性的认知，与其他社区服务无家可归的成年人。在一系列成年人群中实施的认知补救在认知改善和获得社区功能目标方面取得了积极成果。然而，到目前为止，这种认知干预还没有被用于无家可归的青年。认知增益提供了一个必要的学习平台，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成功地采取干预措施，对于阻止功能性残疾不断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一项认知补救的对照研究，提供可行性数据，以适应无家可归的青年，以帮助他们实现职业目标，建立基于认知的干预。最终目的是，青年将改善认知功能，并有更好的功能成果，包括工作，以维持独立生活。这项研究的结果将为一项更大规模的试验提供信息，该试验旨在研究无家可归青年的认知补救措施对改善认知和职业成果的有效性。这项拟议中的研究将涉及90名年龄在18至21岁之间的参与者，他们参加了圣约社的通行权计划，圣约社是一个社区机构，为失业和教育程度低的无家可归青年提供就业培训，补救教育，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对照组相比，接受认知补救的个人将在神经认知的近端测量中显示出更大的认知益处，并证明更好的职业成果，如工作时间更长所定义的。这项研究将解决无家可归的人群使用综合心理社会干预的服务差距作为无家可归的青少年认知补救的第一次调查。 公共卫生相关性：许多无家可归的年轻人有认知缺陷，这阻碍了他们获得和维持就业的能力。这项研究旨在了解针对认知缺陷是否可以改善认知和职业结果。

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.