Cognitive Adaptation Training (CAT) for Schizophrenia

Status: Modest Research Support


Cognitive Adaptation Training (CAT) is designed to improve everyday functioning by teaching the individual with schizophrenia to use strategies that compensate for (or work around) the cognitive deficits associated with schizophrenia. Treatment plans are based on an assessment of the individual’s 1) level of apathy versus disinhibition and 2) level of problem solving impairment. The therapist goes into the patient’s home or work environment and devises compensatory strategies for addressing these challenges. For example, if a person has difficulty initiating self-care activities, signs and checklists to help cue them to remember and to sequence the activities are placed in plain view in the area where the activity is to take place. The intervention typically takes place over several months and includes multiple visits to the client’s home and/or workplace.

Key References (in reverse chronological order)

  • Velligan , DI, Bow-Thomas, C.C., Huntzinger, C., Ledbetter, N., Prihoda, T.J., & Miller, A.L. (2000). Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia. American Journal of Psychiatry, 157(8), 1317-1323.
  • Velligan, D.I., Prihoda, T.J., Ritch, J.L., Maples, N., Bow-Thomas, C.C. & Dassori, A. (2002). A randomized single-blind pilot study of compensatory strategies in schizophrenia outpatients. Schizophrenia Bulletin, 28(2), 283-292.

Clinical Resources

  • Velligan, DI (2000). Cognitive Adaptation Training: The Use of Compensatory Strategies in the Psychosocial Rehabilitation of Patients with Schizophrenia. (Manual for therapists) UTHSCSA, Department of Psychiatry.