Cognitive Enhancement Therapy


If you are looking for a cost-effective and rewarding way to jump-start the psychosocial recovery of your severely mentally-ill clients, then Cognitive Enhancement Therapy (CET) could be the answer. Our new CET Manual is a well tested, comprehensive, step-by-step, user friendly tool that will help your clients acquire the skills needed to advance social cognitive and neurocognitive functioning. Using a small group approach, CET uniquely integrates neurocognitive training with social cognitive group sessions. A reading of the new Manual and an initial application of the exercises should leave you convinced about the opportunity for real client change, and confident that you can indeed apply this cutting edge, empirically tested cognitive rehabilitation approach. You can do this with little or no hands-on training.

What Is CET?

CET is a performance based, comprehensive, developmental approach to the rehabilitation of social cognitive and neurocognitive deficits. Participants work at recovery through structured group and computer exercises. CET is designed as a recovery phase intervention for symptomatically stable persons with severe mental illness, who nonetheless remain socially and vocationally disabled. CET is the culmination of more than 30 years of clinical experience and research in schizophrenia treatment. Overall, CET attempts to increase mental stamina, active information processing, and the spontaneous negotiation of unrehearsed social challenges. It does so with a focus on enhancing perspective taking, social context appraisal, and other components of social cognition.

Does It Work?

CET has been shown to have remarkable and enduring effects in a two year randomized study of 121 persons with schizophrenia or schizoaffective disorder treated with either CET or Enriched Supportive Therapy (EST). Once CET subjects completed the social cognitive groups, highly significant effects were observed for CET on five composite measures (Neurocognition, Processing Speed, Cognitive Style, Social Cognition, and Social Adjustment) at two years. See Figure 1 (Hogarty et al. Archives of General Psychiatry, 2004;61:866-876. Reprinted with permission).


Effect Sizes of CET vs. EST

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Figure 1

Most encouraging, recent findings (Hogarty, Greenwald, and Eack, Psychiatric Services, 2006;57:1751-1757) have shown CET effects to persist for at least an additional year following treatment. Data from an ongoing study of early course schizophrenia subjects indicate a significant CET effect on Emotional Intelligence and the promise of positive change in brain structure and functioning.

Is CET Cost Effective?

CET is cost effective because it relies upon a group approach. Most treatment facilities already have computers. The only additional startup cost is for the neurocognitive computer software (available from independent vendors listed in the manual), the Manual and a CD-ROM used for participant handouts. In facilities where CET has been used, third-party reimbursements have exceeded costs.

How Can I Learn to Apply CET?

Cognitive Enhancement Therapy: The Training Manual by Professor Gerard E. Hogarty, M.S.W. and Dr. Deborah P. Greenwald, Ph.D. and their accompanying CD-ROM that provides participant handouts, are now available! The Manual describes, step-by-step, each of the 45 social cognitive group sessions and the 16 graduated, computer assisted exercises in neurocognitive training.

The CET manual can be purchased by completing the printable CET Manual Order Form, and sending check or money order for $50.00 plus $4.50 shipping and handling (within the USA) payable to CET Training, LLC to:

CET Training
P.O. Box 11522
Pittsburgh, PA 15238

The CET CD-ROM, which includes session agendas, participant handouts, exercises and assessments, can be purchased for an additional $25.00 at the above address. (A single facility only needs one CD-ROM. Each CET clinician would want their own Manual.) Five or more Manuals can be purchased for $45.00 each (plus shipping and handling).

The 433 page CET Manual contains the following components:

Section I - Preparing for CET - This section describes the role of the CET therapist, the appropriate client population, baseline assessments, the process of coaching and developing coaching plans, how to form a CET group, and lists the necessary CET materials.

Section II - The Social Cognitive Group Curriculum - This centerpiece of CET describes each of the 45 CET weekly group sessions, including the homework, the exercise, its feedback and the education topics that characterize most sessions. All participant handouts are provided on the CET CD-ROM arranged by session. (Note: Except for the education topic in Session 2, the exercises are diagnostically non-specific. If clinicians wish to serve people other than those with schizophrenia or schizoaffective disorder, a separate talk for the diagnosis of interest will need to be created.) Clinical examples of CET interventions are also offered.

Section III - Training in Attention, Memory and Problem Solving - This section describes computer assisted training in attention, memory and problem solving (3 attention exercises, 7 memory tasks and 6 problem solving exercises). Computer assisted training is an effective medium for increasing participant socialization and building mental stamina as well. The 2 software packages used in CET for computer assisted training exercises can be purchased separately. The first package can be obtained by contacting David Biderman, Ph.D. (David.Biderman@nyumc.org). The second package can be obtained by contacting Odie Bracy, Ph.D. (www.neuroscience.cnter.com).

The Manual concludes with various appendices that describe an eligibility interview, assessments of cognitive styles and social cognition, and bibliography.

Other Sources:

Some of the CET principles have been greatly influenced by our earlier Personal Therapy approaches to stress reduction and psychoeducation. The CET practitioner would profit from learning about these complimentary Personal Therapy techniques. Personal Therapy For Schizophrenia and Related Disorders: A Guide to Individualized Treatment by Professor Gerard E. Hogarty, M.S.W. is available from Guilford Press, New York 2002.

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