Goal Management Training for Patients With Schizophrenia, Psychosis Risk

A 5-week, group-based Goal Management Training program was effective in improving self-assessed executive function in patients with schizophrenia spectrum disorders and psychosis risk syndromes, researchers reported in BMC Psychiatry.

“Executive functioning is essential to daily life and severely impaired in schizophrenia and psychosis risk syndromes,” wrote study lead and corresponding author Ingvild Haugen, PhD candidate at the University of Oslo in Norway, and coauthors. “Goal Management Training is a theoretically founded, empirically supported, metacognitive strategy training program designed to improve executive functioning.”

The study randomized 39 participants to 5 weeks of Goal Management Training and 42 participants to treatment as usual. The majority of participants were recruited through a hospital clinic that focuses on the early detection and intervention for psychosis, resulting in a younger sample of patients between the ages of 16 and 44. Among participants, 16 were diagnosed with psychosis risk syndromes and the remainder with schizophrenia spectrum disorder.

Self-reported executive functioning, as measured by the Behavior Rating Inventory of Executive Function – Adult version (BRIEF-A), improved significantly more with Goal Management Training compared with treatment as usual. The largest effects of the training on BRIEF-A subscales were in initiating activities, planning/organizing, self-monitoring, and shifting focus between activities. Researchers reported a significant group-by-time interaction effect assessed immediately after the training and at a 6-month follow-up.

Both groups showed improvement in objective executive functioning as measured by neuropsychological tests, functional capacity, daily life functioning, and psychosis symptoms rated by clinicians. However, self-reported clinical symptoms measured with the Symptoms Check List improved significantly more in patients who received Goal Management Training compared with treatment as usual.

“Goal Management Training proved to have clinically reliable and lasting effects after being administered in groups over a brief period of 5 weeks. Participants also reported less anxiety and depressed mood after intervention,” researchers wrote. “Thus, this suggests that Goal Management Training can provide considerable gains at low cost in clinical settings.”

Reference:
Haugen I, Stubberud J, Haug E, et al. A randomized controlled trial of Goal Management Training for executive functioning in schizophrenia spectrum disorders or psychosis risk syndromes. BMC Psychiatry. 2022;22(1):575. doi:10.1186/s12888-022-04197-3