CET (Cognitive Enhancement Therapy) is a recovery oriented, SAMHSA recognized, Evidence Based Practice. CET helps individuals develop and enhance the mental capacities that produce the awareness for self-directed social interactions that are wise, appropriate, and effective. (CET is not Cognitive Behavioral Therapy, please see CBT or CET on the FAQ's page). While CET was initially developed to help individuals recovering from schizophrenia, it has also proved effective for persons recovering from schizoaffective disorder, bipolar disorder, major depression and high-level autism. SPECIAL NOTICE: CET ON NAMI'S ASK THE DOCTOR
Samuel M. Flesher, Ph. D., the co-developer of CET, was recruited by PLAN of NE Ohio to come to Cleveland in 2000 to establish the first CET Program outside of academia. Over the next nine years, the CET Program in Cleveland was extensively field tested and refined under the guidance of Dr. Flesher. A user friendly manual was written and is continually being updated.
Starting in 2004, CETCleveland ™ has been or is being disseminated to 21 sites in ten states. Over 130 CET groups have been completed; 32 groups are currently being run and three groups are in the process of recruiting members. All the sites report similar results with 85 to 90% attendance rate, 85% graduation rate and CET graduates truly progressing in their recovery. To see the results of the Bridgehaven MHS CET dissemination training please go to YouTube and enter CET Bridgehaven or click here .
On October 30th, 2012, InterAct of Michigan Inc. in Kalamazoo, MI began the dissemination training to become the 16th CET Cleveland™ site. In Delaware, Connections Community Support Programs started on March 13; Spindletop Center in Beaumont TX started March 7; Didi Hirsch, a 70-year-old CMHC with 11 sites in Los Angeles County, CA, recently received a Primary Care & Behavioral Health Care Integration Grant from SAMHSA. The grant will fund establishing a CET Cleveland™ Program for their Health Home Initiative. By increasing the cognitive functioning of their clients thru CET, the clients will be better able to communicate with Primary Health Care Providers thus improving their physical health as well as their mental health. Initial training began March on 28, 2013.
Lake Shore Behavioral Health Inc., Buffalo, NY started CET Training on March 25, 2013 with funding from the Patrick P. Lee Foundation. Horizon House of Delaware started their CET Training on April 24, 2013. And starting in June, the Veteran Affairs Outpatient Dept. in Cleveland and The Mental Co-op in Houston Texas will begin their CET Training.
Currently there are seven dissemination sites in development across the USA: California, New Jersey, Ohio, Oregon, North Carolina, Pennsylvania and Texas.
CETCleveland™ is a program offered by the Center for Cognition and Recovery, LLC (CCR). The CCR is a non-profit endeavor developed by JFSA of Cleveland and PLAN of NE Ohio, Inc. to disseminate CETCleveland™ to other mental health providers. CETCleveland™ has truly been a transformative treatment for our clients, their families, our staff and our organizations. We want to share this remarkable treatment as widely as possible. The Center for Cognition and Recovery has been awarded the SAMHSA 2011 Science and Service Award for our work in disseminating CET.
Call Ray Gonzalez at 216-504-6428 for more information on how to set up a CET Cleveland™ Program in your community.
CET will be a Special Sessions Presentation at the NAMI National Convention in San Antonio on Thursday, June 27. This is a follow up to the presentation that Dr. M. Keshavan mad to more than 500 attendees on CET as the featured topic at the Research Plenary at last year's NAMI Convention in Seattle. Ray Gonzalez also conducted a workshop on CET then for over 120 attendees: "An Evidence Based Practice that delivers successful social and vocational functioning". The PowerPoints can be found at the NAMI Convention website, click here
To see video clips of Focus Group of CET graduates
andfamily members talking about how CET has
changed their lives, please go to Testimonials Page.
Ask the Doctor: Teleconference Series
NAMI's Ask the Doctor teleconference is a monthly series hosted by NAMI's Medical Director, Dr. Ken Duckworth. The April 26th Conference Call was with Ray Gonzalez, ACSW on Cognitive Enhancement Therapy (CET). Please google NAMI Ask the Doctor to hear a recording of the progam
The CCR has been awarded SAMHSA's
2011 Science and Service Award
Every year the Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes organizations that "demonstrate successful implementation of a recognized evidence-based intervention". The CCR is greatly honored to be recognized by SAMHSA for our efforts. Please click here to view the announcement
An article on CET is in the NAMI Spring 2013 Advocate as well as 2 Articles on CET featured in the NAMI 2011 Fall Advocate Magazine, including an interview with a CET graduates; please see sidebar
A Meta-analysis of Cognitive Remediation for Schizophrenia by Til Wykes, et al, (Published in the American Journal of Psychiatry, May 2011) found that the results from cognitive remediation can be generalized but “What is more important than the surface characteristics (e.g., using a computer) is the technique of specific and explicit training of strategies and the use of various transfer techniques, as shown in the improved functioning outcomes for these approaches.” CET is clearly a form of cognitive remediation that is strategic in nature with a psychiatric rehabilitation focus.
"Conclusions: cognitive remediation benefits people with schizophrenia, and when combined with psychiatric habilitation, this benefit generalizes to functioning, relative to rehabilitation alone." (Please see research page for copy of the abstract)
CET was developed as a form of cognitive remediation with a strategic approach to help in the psychiatric rehabilitation of persons recovering from schizophrenia and related illnesses. Dr. Wykes' study validates this approach and explains, in part, the successes that we have found with CET.
The NAMI "Ask the Doctor" April 29th teleconference with Dr. Matcheri Keshavan on Cognitive Enhancement Therapy (CET) is available as a podcast. http://www.nami.org/Content/ContentGroups/Ask_the_Doctor1/Ask_the_Doctor.htm
The following review is by Luci Keazer from the NAMI Lafayette Indiana Chapter:
I listened this weekend and thought it was excellent, except for the background chatter of listeners who didn't mute their phones! The prepared presentation is ~20 minutes followed by a lengthy Q & A session. Dr. "Kesh" describes CET as being important in improving the cognitive impairment that is part of serious mental illnesses (SMI), particularly schizophrenia, schizo-affective disorder, and serious bipolar disorders.
He discusses how to improve cognition, what approaches work, where CET is available, and resources. He asserts that the core problem of SMI is impairment in cognition. Impairments include difficulty paying attention, memory, problem solving, thinking through and deciding (executive function), engaging in social interactions and interpreting social cues. These cognitive impairments make it difficult to maintain work, for daily functioning, and for relationships. Psychiatric medications, while effective for psychosis, are ineffective or only slightly effective in improving the cognitive impairments typical of SMI.
CET consists of systematic, simple cognitive exercises on computers coupled with weekly social cognitive group sessions for one to two years. Therapies improve cognition, help job success, and change the brain. "The more neurons fire together, the more they wire together." Brain training is comparable to physical exercise, it needs to be done regularly, start gradually, and have a purpose and motivation.
I also checked out and tested some free cognitive sessions at one of the recommended brain fitness websites. Dr. Kesh recommended CET in a social setting as it amplifies the benefit over just computer training. I encourage you to listen to this podcast if you want to know more about CET. I briefly summarized it because our Community Collaborations committee is planning a CET educational presentation in September by Ray Gonzalez, Executive Director of Center for Cognition and Recovery www.cetcleveland.org , also recommended by Dr. "Kesh". More information on that will be coming later.
I first heard of CET last fall when two NAMI Family to Family class members researched it and shared with our class. There is evidence that CET is an important piece of the recovery from serious mental illnesses.
Best wishes to you,
Luci Keazer
CET was featured in the Harvard Mental Health Newsletter’s October 2010 edition. The Newsletter article gives a comprehensive review of the most recent research done on CET with a focus on early course of schizophrenia. Please see link to the right to download your copy of this article. Also see the research page for additional articles on CET.