Integrating Shaping and Skills Training Techniques in the Treatment of Chronic Treatment Refractory Individuals with Schizophrenia

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Abstract
Attentional impairment is both a core characteristic of schizophrenia and a factor in producing poor outcomes in rehabilitative treatment. While cognitive rehabilitation interventions have demonstrated some success, the severity of some clients' attentional impairment is such that they cannot attend to material in these treatments, leading to unsatisfactory outcomes. Several reports now indicate that shaping techniques can be used with severely attentionally impaired individuals to increase time on-task to the point where they can eventually participate in more traditional rehabilitation programming. This, however, often requires the person to be absent from skills training for several months. In this report, we describe procedures wherein shaping and skills training are administered simultaneously in an integrated fashion. Results indicate that this can be an effective technique to enhance attentional functioning and participation among attentionally disordered patients in skills training groups.