Evaluating social cognitive remediation for labour participation in severe mental illness: insights from a small-scale randomised controlled trial
In brief
Social cognitive training increased expected work hours by 6.5% in severe mental illness
In this small randomized trial, a 12-week social cognitive remediation program increased the share of expected work hours completed by 6.5% in the intention-to-treat analysis; the per-protocol increase was 3.6%. Internalized stigma also fell at six months, but 37% of participants dropped out by follow-up, so larger trials with better retention are needed to confirm the benefits.
- Journal
- BJPsych open (Q1)
- Published
- 12 October 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Guillaume Barbalat, Julien Plasse, Marie-Cécile Bralet, Sophie Cervello, Nicolas Franck
- PMID
- 42860866
- DOI
- 10.1192/bjo.2026.12124
Why clinicians should know about it
- Picked for Psychiatry and Mental Health (paper of the day, 13 October 2026): Social cognitive remediation improves employment in severe mental illness
Abstract
BACKGROUND: Employment rates remain critically low among individuals with severe mental illness. Although social cognition explains a significant portion of the variance in functional outcomes, research into social cognitive interventions has remained scarce. AIMS: To evaluate the impact of a social cognitive remediation (SCR) programme on functional and psychological outcomes over a 6-month post-intervention period. METHOD: This randomised controlled trial was conducted across three sheltered employment centres in France (2020-2024; ClinicalTrials.gov protocol record: 2019-A00124-53). We evaluated the efficacy of a 12-week SCR programme versus an active control with respect to the ratio of hours effectively worked versus those expected at 6 months post treatment (primary outcome). Secondary outcomes included patient-reported measures of self-esteem, internalised stigma, recovery and anxiety. Intention-to-treat and per-protocol effects were estimated using targeted minimum loss-based estimation, with attrition accounted for through inverse probability of censoring weights. RESULTS: Of the 105 randomised participants (SCR: n = 53; control: n = 52; mean age: 35.6 [s.d. = 8.8] years; 71% male), 39 dropped out, yielding a per-protocol sample of 33 participants per arm. Attrition was 28% immediately after the intervention and 37% at 6-month follow-up. SCR was associated with a 6.5% increase in the ratio of hours worked versus those expected in the intention-to-treat analysis and a 3.6% increase in the per-protocol analysis (both P < 0.05). SCR also reduced internalised stigma at 6 months post treatment (P < 0.03). CONCLUSIONS: Our findings suggest that a 3-month SCR programme improves employment maintenance and reduces internalised stigma in individuals with severe mental illness. Future research should use larger samples and improve retention to confirm these findings.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.