Cognitive Adaptation Training Cognitive Adaptation Training (CAT) is a treatment that circumvents cognitive impairments by rearranging the environment to support, prompt and sequence appropriate behaviours. CAT has shown promising results, including improved social functioning. As yet, no reports have appeared on the use of CAT in combination with Assertive Community Treatment (ACT).

To evaluate the effect of CAT in comparison with ACT, focusing on social functions (primary outcome), symptoms, readmission, and quality of life of outpatients with schizophrenia.

To conduct a randomised clinical trial to test the effect of CAT compared to ACT on primary and secondary outcome.

From January 2009 to September 2010, 62 patients from three early intervention centres (where ACT was a principal part of the treatment) were enrolled in a randomised clinical trial. The effect of CAT was assessed at six and nine months.

The results indicated no significant difference between intervention group and control group at six and nine months for any outcome. The results indicated no significant difference on primary outcome GAF-F at six months (p= 0.32) or nine months (p= 0.34).

The results from this trial differ from previous CAT trials; this is the first trial without significant results in comparison with treatment as usual. However, the low number of patients in the trial may have resulted in accepting a false null hypothesis, giving a type II error. Further studies are needed to determine if some elements from CAT can make ACT more economically effective.