Feuerstein Instrumental Enrichment Program for People With Schizophrenia After the First Episode of Psychosis: Protocol for an Open-Label Intervention Study

Background: Schizophrenia is a disorder associated with neurocognitive deficits that adversely affect daily functioning and impose an economic burden. Cognitive rehabilitation interventions, particularly during the early phases of illness, have been shown to improve cognition, functionality, and quality of life. The Feuerstein Instrumental Enrichment (FIE) program, based on the Mediated Learning Experience and the Structural Cognitive Modifiability theory, has been applied in various disorders, but its applicability in schizophrenia has not yet been clarified. Objective: This study aims to investigate the effects of the FIE program on the functionality of patients with first-episodeschizophrenia. Methods: In total, 17 patients will be recruited for an open-label intervention consisting of twice-weekly sessions for 10 weeks. The primary outcome measure will be changes in the Goal Achievement Scale score. Maze task performance from the Measurementand Treatment Research to Improve Cognition in Schizophrenia (MATRICS) battery will serve as a secondary outcome measure.At the same time, changes in Positive and Negative Syndrome Scale scores and other MATRICS domains will be analyzed asexploratory outcomes. Assessments will be administered before and after the intervention, with a follow-up period of 6 months. Results: This trial was preregistered in The Brazilian Registry of Clinical Trials (RBR-4gzhy4s). By February 2024, 11participants were enrolled in the training. Recruitment is expected to be completed by May 2024. Data analysis will be conductedbetween May and September 2024. The results are expected to be published in January 2025. Conclusions: This study may establish a protocol for the FIE program that uses mediation techniques for individuals in theearly stages of schizophrenia. The results will add to the knowledge about strategies to promote cognitive skills and functionalimpairment in daily life.