Intervention Adherence
psychotic disorders, schizophrenia, first-episode psychosis
REGRESSION
The dropout rate of this study was 22% (22/100), which is lower than that in our previous studies of TCT in adults with persistent schizophrenia and with recent-onset psychotic disorders where training was completed remotely (where it was 30% [Although retention in both the TCT and CG groups was higher in this study than in similar studies without PRIME, the TCT participants showed a lower weekly training intensity, likely reflecting the greater effort and difficulty of engaging in TCT exercises. The completion of the training remotely may have also contributed to the lower training intensity. Our prior study of TCT completed in person in the research setting showed an average training intensity of approximately 5 hours per week [To retain blinding, the coaches were instructed to redirect discussions that might reveal specific details of the specific computer module a participant was engaged in (TCT or CG). Although critical to the design of a randomized controlled trial, this practice created obstacles to meaningful conversations about the effortful nature of cognitive training and inhibited motivational troubleshooting regarding the training itself. In a separate study of first-episode psychosis, we are currently investigating the effects of cognitive training provided with PRIME versus treatment as usual using a regression discontinuity design. In this study, discussion of the training between participants, coaches, and peers is encouraged and embedded in the treatment planning for the individual [