Project Summary

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

Schizophrenia is a serious mental health problem that can affect how a person thinks, feels, and behaves. It may limit people’s social skills as well as thinking skills such as learning and problem solving. Standard treatment for schizophrenia includes medicine and therapy. Problems with social and thinking skills are usually treated with therapy.

In this study, the research team is comparing two types of therapy for improving social and thinking skills in people with schizophrenia:

Cognitive enhancement therapy, or CET, uses computer training and group exercises to improve brain function and social skills.

Social skills training, or SST, uses techniques such as role-playing, constructive feedback, and guided practice to improve social skills and interaction with others in community settings.  

The research team wants to see how well the therapies improve social and thinking skills. They are also looking at how different groups of patients, such as older or younger patients, respond to each therapy.

Who can this research help?

Results may help mental health clinics when considering ways to improve social and thinking skills in people with schizophrenia.

What is the research team doing?

The research team is working with 19 mental health clinics in New England to recruit 378 people with schizophrenia. The team is assigning clinics by chance to offer either CET or SST. All patients receive treatment for one year with either CET or SST.

CET focuses on helping patients improve thinking skills through weekly computer sessions that pairs of patients complete together. A clinician helps pairs work together. Patients also take part in weekly 1.5-hour group classes led by a clinician and assistant. Classes include brief lessons, homework, and group exercises that focus on skills such as understanding other people’s perspectives and how to read social cues. Clinician trainers meet weekly with individual patients for therapy sessions. Trainers also meet with a supervisor to discuss how the computer training and group classes are going and to receive guidance on improving both.

SST uses role-playing and constructive feedback to improve social skills. Patients receiving SST attend 90-minute skills training classes weekly for one year. Each class includes an overview of a specific skill followed by practice of the skill using role-play. Classes cover topics such as effective communication, making and keeping friends, and how to take medicines correctly. Patients also go on trips to sites in the community such as stores and parks to practice skills, supported by clinician trainers.

The research team is assessing patients’ social and thinking skills at the start of the study and again 6, 12, 18, and 24 months later, including

  • Ability to interact socially in the community
  • Schizophrenia symptoms
  • Social skills
  • Verbal ability
  • Memory
  • Ability to recognize emotions in oneself and others
  • Motor skills
  • Speed at which one can understand and react to information
  • Ability to concentrate
  • Executive functioning skills like problem-solving and self-control

The research team is comparing these outcomes between CET and SST therapies. The team is also looking to see how well each therapy works for patients who have more or fewer thinking problems, and for those who are younger or older.  

Patients and staff from mental health centers are helping with this study.

Research methods at a glance

Design Elements Description
Design Randomized controlled trial
Population 378 adults ages 18–65 with a diagnosis of schizophrenia or schizoaffective or schizophreniform disorder
  • CET
  • SST

Primary: ability to engage socially in community settings, negative schizophrenia symptoms, social skills

Secondary: verbal ability, working memory, emotional intelligence, positive and negative symptoms, motor skills, processing speed, control and attention, executive function

Timeframe 2-year follow-up for primary outcomes

Project Information

Matcheri S. Keshavan, MD, and Russell K. Schutt, PhD
Beth Israel Deaconess Medical Center
Comparative Effectiveness of Cognitive Enhancement Therapy versus Social Skills Training in Serious Mental Illness

Key Dates

August 2019
August 2026

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: September 26, 2023