Zuidlaren

Researchers are investigating whether cognitive remediation (CR) training can help people with severe mental illness (SMI) who need supported housing due to severe cognitive and daily living problems. The study also explores if combining CR training with mild brain stimulation called transcranial Direct Current Stimulation (tDCS) can improve the effects of CR training. This trial is designed to evaluate improvements in daily functioning, cognitive skills, and personal goal achievement in people with SMI who experience persistent challenges in multiple areas of life. Participants will receive 16 to 20 weeks of cognitive remediation training twice weekly using a program called CIRCuiTS, which focuses on improving cognitive and metacognitive skills and applying these skills in daily life. They will be randomly assigned to receive either active tDCS brain stimulation or sham (inactive) tDCS alongside the CR training. The brain stimulation is applied to promote neural plasticity during cognitive exercises by gently altering brain activity in key areas. The study uses a triple-blinded, sham-controlled design across multiple centers. Participants will be assessed at several points: baseline (16 weeks before treatment), pre-treatment, post-treatment (after 16 to 20 weeks of training), and 6 months after treatment ends. Evaluations include questionnaires on independent living skills, goal attainment, social functioning, and continuous monitoring using the Behapp application during the entire study period, which may last up to 16 months. Optional in-depth interviews will explore participants' experiences with the training and its impact on their cognition and daily life. The study aims to determine if CR alone or combined with tDCS can enhance recovery and be recommended for standard care in SMI.