# Cognitive Adaptation Training: Effectiveness in real-world settings and Mechanisms of Action (CAT-EM)

> **NIH NIH R01** · UNIVERSITY OF TEXAS HLTH SCIENCE CENTER · 2021 · $546,504

## Abstract

Abstract
Schizophrenia remains one of the most disabling conditions world-wide with an economic burden that
exceeded $155 billion dollars in fiscal year 2013 alone. Despite existing medication and community treatment,
many individuals with this diagnosis continue to have poor outcomes and struggle toward recovery. CAT is a
psychosocial treatment using environmental supports such as signs, alarms, pill containers, checklists,
technology and the organization of belongings established in a person's home or work environment to bypass
the cognitive and motivational difficulties associated with schizophrenia, and support habits for functional
behavior to promote recovery. In a series of efficacy studies, CAT improved social and occupational
functioning, symptoms, and adherence to medication, and reduced rates of readmission. We propose a cluster
randomized effectiveness trial comparing Cognitive Adaptation Training (CAT) to existing community treatment
(CT) for individuals with schizophrenia in 8 community mental health centers across multiple states including
400 participants. This would be the first large-scale effectiveness study of CAT for improving functional
outcomes for those with schizophrenia seen in community mental health centers (CMHCs) where the majority
of those with schizophrenia are followed for outpatient care and to study the purported mechanisms of action
based on an integrated theoretical model. Participants will be assessed at baseline and 6 and 12 months on
measures of functional and community outcome, medication adherence, symptoms, habit formation and
automaticity, cognition and motivation. CAT treatment will be weekly for 6 months, biweekly for 3 months and
monthly for the remainder of the trial. Purported mechanisms of action for CAT including bypassing
impairments in cognitive function to improve functional outcome and bypassing motivational impairments to
create automatic habits to improve functional outcome will be examined.

## Key facts

- **NIH application ID:** 10166942
- **Project number:** 5R01MH117101-04
- **Recipient organization:** UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
- **Principal Investigator:** Dawn Irene Velligan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $546,504
- **Award type:** 5
- **Project period:** 2018-09-01 → 2023-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10166942

## Citation

> US National Institutes of Health, RePORTER application 10166942, Cognitive Adaptation Training: Effectiveness in real-world settings and Mechanisms of Action (CAT-EM) (5R01MH117101-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10166942. Licensed CC0.

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