[Upbeat music plays as the camera shows a man sitting on a couch watching TV. Text on the screen reads, “Cognitive Adaptation Training: Middle to Late Phase.” The camera briefly fades to black then fades back in to show Gabriel, a participant in the pilot program sitting down on a couch with Dawn, his CAT therapist. Gabriel is wearing a white t-shirt and pants.]
Dawn Okay, Gabriel, you did a great job this week. You’re using all your hygiene products and filling up your laundry basket. That’s really good!
Gabriel Thank you.
Dawn Now, before I left last week, you mentioned to me that your brother was kind of on your case because he doesn’t think you do enough around the house and during the day. What do you think about that?
Gabriel Well, I take my showers. Um,…
[Pause.]
Dawn Okay.
Gabriel I take my meds.
Dawn Good, good, good.
Gabriel What else does he want?
Dawn I don’t know.
Dawn What I thought we could do is we could get some data about what it is that you do during the day, so what I brought with me is this schedule and on the schedule you have the days of the week and you have all of the hours of the day. So what I’m going to want to do is explain to you how to fill this out so that by the end of the week, we’ll know everything you did and we’ll be able to see what you think about that. Does that make sense?
Gabriel Yes.
Dawn Okay. So today, for example, today is Thursday. What time did you get up?
Gabriel I woke up at about one or two.
Dawn About one or two, okay. So you were asleep pretty much almost until I got here, right?
Gabriel Yes.
Dawn And what did you do before I got here?
[Dawn shows Gabriel the schedule and begins filling it in while he watches.]
Dawn So right in here, we start at seven and we go down to about one or two and we write, “sleep,” okay? What did you do before I got here?
Gabriel I showered.
Dawn And you had to get dressed, right?
Gabriel Yes.
Dawn You showered and you dressed. What else?
Gabriel Well, like they say in the service, “Shit, showered, and shaved.”
[Dawn chuckles.]
Dawn Okay. So you got ready for the visit and now during this hour from two to three, we’re having the visit. So what I want you to do is after I leave, I want you to write down what you’re doing in all these hours. So, say for example you watch the television, I want you to write “TV” or if you go to the store, you just write “store” so we’ll know how you’re spending your time during the day. Now this one is going to be yours. That was an example. So if you can start by filling out what you’ve done today, what you told me, then we can see how it works, okay?
[Dawn hands Gabriel a blank schedule page and a pen and he begins filling it out.]p>
Dawn So you’re drawing a line. Okay. Write in it real big, “sleep.” Okay, I can see that. That’s good I can see that because I have trouble with my eyes. Alright, and then down here you’re going to want to write what you did: taking your shower, taking your medication. Good. Okay, so that’s what I want you to do with this during the week. Does that sound okay to fill this out?
Gabriel That sounds fine.
Dawn And do you understand why we want to do this?
Gabriel Yes, you went over it.
Dawn So, we want to get some ideas about what’s really going on and then next week we’ll come and we’ll look at this, and we’ll talk about what you think about how you’re doing because I’m more interested in how you think you’re spending your time and whether you like that. Not so much what your brother thinks about it, okay?
Gabriel Okay.
Dawn Now, is it okay if I call you a couple of times during this week just to remind you to fill this out? Sometimes people forget.
Gabriel Okay, it’s fine, just fine.
Dawn Okay, so I’ll give you a couple of calls and make sure that you’re filling this out and then we’ll take a look at it next week, okay?
Gabriel Okay.
Dawn Alright, so I’m going to leave this with you and I’m going to put my stuff down over here, and we’re going to go out to the car and get some of the other things that I brought, okay?
Gabriel Okay.
[The screen fades to black and has text that says, “One week later.” The screen fades back in to show Dawn and Gabriel seated in his living room. Gabriel is dressed in pants and a polo shirt. Dawn is looking over the schedule that Gabriel filled out during the course of the week.]
Dawn Wow, Gabriel, you really put a lot of effort into this. There’s a lot of detail here. It talks about everything that you’ve done so this is great! So let’s talk about what’s written here and get your opinions.
[Gabriel nods.]
Dawn Okay, so it seems like most days you’re waking up about two o’clock in the afternoon or so and some days it’s a little bit later and some days it’s a little bit earlier. Okay, so a lot of sleeping, and what else do you see written down?
[Dawn shows the schedule to Gabriel.]
Gabriel Showered, meds, shaved, TV, TV, TV.
Dawn A lot of TV, okay, and there’s also naps here and there. Okay, so I want you to take a look at this and tell me – here’s the whole week long thing so that you can see – and tell me what you think about this. Is that the way you want to spend your time?
Gabriel Yes.
Dawn Is that how you want your days to go? Yes, you like this?
Gabriel Yes.
Dawn Okay. Now, suppose next week was exactly like this week and it was exactly the same, would that be good for you?
Gabriel Yes.
Dawn So you’re satisfied with this?
Gabriel Yes.
Dawn Okay, now let me ask you this, suppose that every week for the next year looked like this, what would you think about it then if every week in the next year looked like this?
Gabriel Maybe my brother has a point.
Dawn What do you mean?
Gabriel Well, I don’t do enough in the house.
Dawn You don’t do enough? Okay, so how would you feel about yourself if every day for the next year was like this?
Gabriel I wouldn’t feel very good about myself.
Dawn Okay so if your year was like this every day, you wouldn’t feel very good about yourself?
Gabriel That’s correct.
Dawn Okay. If you looked back in a year, how would you want it to look? What would you want to be in here?
[Pause.]
Dawn You mentioned doing more. What more would you like to do?
Gabriel Going to church meetings, exercise, shopping, laundry.
[Dawn begins writing down the activities that Gabriel is listing.]
Dawn Okay, so you’d like to do things like exercise, shopping, laundry. Anything else that you might want to do?
Gabriel Go for brisk walks. Look for a job.
Dawn Look for a job?
[Gabriel nods.]
Dawn Well, you know, those are some really good goals. Before you can look for a job, is there anything you would need to do differently with your day, do you think? So, if looking for a job is a goal, is there anything you’d need to do differently?
Gabriel Get up earlier.
Dawn You’d have to get up earlier. Yeah, I think that one of the things that people do sometimes is that they see this and that they’re not doing much and that they’re sleeping and napping a lot and they say, “Oh, I want to get a job,” but it’s hard to get a job when you’ve spent a lot of time just sitting around. You’ve got to kind of get in the swing of things first and one of the things we recommend is following a daily schedule. What do you think about that? Would you be willing to try that?
Gabriel Definitely.
Dawn You would?
Gabriel Yes.
[Dawn begins filling out a schedule for Gabriel.]
Dawn Okay, so if you were going to make up your own schedule and make this look like you wanted it to be, what time would you like to start getting up?
Gabriel Nine o’clock.
Dawn Nine o’clock in the morning?
Gabriel Yes.
Dawn So that’s quite a big difference, you know. One of the things you might want to do is start at ten for the first week and see how that goes.
Gabriel Okay.
Dawn And then, if that’s going fine, you can push it back a little bit. Does ten o’clock sound reasonable?
Gabriel Yes.
Dawn Okay. So, we don’t want to set our goals too high. We want to make sure it’s something you can do, so ten o’clock.
Gabriel Okay.
Dawn If you were going to get up at ten o’clock, what would you want to do next after you got up?
[Pause.]
Dawn So you mentioned that you shower and take your medicine. Would that still stay the same?
Gabriel Yes.
Dawn Then after your showered, what might you want to do?
Gabriel Do some cooking.
Dawn What would you cook?
Gabriel Eggs Benedict.
Dawn Eggs Benedict! You know how to cook that?
Gabriel Yes.
Dawn You’ll have to teach me because I don’t really know that one. Eggs Benedict, good one. Okay, so you’d cook Eggs Benedict. Would that be just for you or for your family?
Gabriel Just for me.
Dawn Just for you? You’d make it for yourself, and your family can just suffer?
[Dawn laughs.]
Gabriel Yes.
Dawn Okay, so you’d make Eggs Benedict. What other things would you want to do after you ate breakfast? So you’ve got waking up and you’ve got your cooking that goes to here, and then what would you want to do the next couple of hours?
Gabriel Laundry.
Dawn Would you do laundry for the whole family?
Gabriel No, just for me.
Dawn Just your own laundry, okay. So you’d do laundry and how long would that take?
Gabriel Two hours.
Dawn You think two hours?
Gabriel Or an hour and a half.
Dawn Okay, so we’ll put in two hours just to be on the safe side for laundry.
[Dawn shows Gabriel the schedule she has been filling out.]
Dawn Okay, so does that look okay?
Gabriel Yes.
Dawn Okay, and then after laundry, what do you think you might want to do?
Gabriel Take a nap.
Dawn Okay, so we’ll put that in. How long of a nap?
Gabriel Thirty minutes.
Dawn Thirty minutes? Now, your naps on here were quite a bit longer. How would you get yourself to wake up after thirty minutes only?
Gabriel I’d set an alarm.
Dawn You’d set an alarm. Okay, that’s a good idea. Like the one on your phone or something?
Gabriel Yes.
Dawn Okay, so now you’ve woken up from your nap and you’ve got pretty much the afternoon. What do you think you’d like to do with the rest of your afternoon?
Gabriel Watch TV.
Dawn Okay, what do you watch?
Gabriel Emilio Estevez’s brother. I don’t know his name.
Dawn Okay, so he has a show?
Gabriel He’s got a show. I think it’s “Two Men and a Baby”.
Dawn Okay, so you like to watch that. So you’d watch TV during the day, okay. How long do you want to watch?
Gabriel Two hours.
Dawn About two hours? Okay. Okay, so after you did that, what kind of things might you want to do?
Gabriel Exercise.
Dawn Okay, what do you do for exercise?
Gabriel I take brisk walks.
[ Dawn hands Gabriel the pen and schedule.]
Dawn Okay, so why don’t you start working on this? So from this time to this time you can put in “brisk walk.” Good. Okay, and then what we’re going to do is fill in the rest of this plan and then during the week we’ll see whether or not you can follow it and how it went for you, okay?
Gabriel Okay.
Dawn Okay, so let’s keep going.
[The screen fades to black and the text reads, “4 weeks later.” The screen fades back in to show Dawn and Gabriel sitting at a kitchen table. Gabriel is dressed in a short-sleeved button-down shirt, tie, and slacks.]
Dawn Okay, Gabriel, you’ve done a great job over the past month following your schedule and as things changed you added new stuff. I really like that you started volunteering! I’m so impressed with how you’re doing! How do you feel about it?
Gabriel I feel wonderful.
Dawn You do? Has anybody said anything to you?
Gabriel My family is happy because I’m helping around the house.
Dawn Your family is happy. And also you’re getting out more.
Gabriel Yes.
Dawn Are you enjoying your life more, would you say?
Gabriel Oh yeah.
Dawn Well, good! I’m really glad this is working out. When we started this whole daily scheduling thing, you told me that one of your goals was maybe to get a part-time job so what I’ve done is I’ve brought something called, “A Readiness Ruler.”
[Dawn shows Gabriel a piece of paper.]
Dawn What this means is that we look at this scale from one to ten and you can see one means you’re not at all ready and ten means you’re extremely ready – the most ready you can think of – to start a job. What I want you to do is on this scale of one to ten, I want you to circle how ready you are to make a change.
Gabriel Okay.
[Gabriel picks up a pen and circles a number on the sheet of paper.]
Gabriel I’m going to circle number nine.
[Gabriel circles a number on the paper.]
Dawn You’re going to circle number nine. So you’re pretty ready to make a change?
Gabriel Yes.
Dawn How come this isn’t a seven or an eight?
Gabriel I’m almost at the pinnacle of being ready to get a job.
Dawn So you’re almost at the highest you can be?
Gabriel Yes.
Dawn Okay. Why aren’t you at the highest?
Gabriel I’m not at the highest because I’m not extremely ready.
Dawn Okay. So you don’t think “extremely” fits that?
Gabriel No.
[Dawn shows Gabriel another piece of paper.]
Dawn Okay, this is another one that just talks about on a scale of one to ten, how important is it for you to get a part-time job, would you say? A one is not at all important to you and a ten is extremely important. So, where would you put yourself on how important it is to get a job? I’ll let you circle it.
[Gabriel circles a number on the paper.]
Gabriel I would circle number ten.
[Gabriel circles a number on the paper.]
Dawn You would circle number ten? Okay. So this is really important to you?
Gabriel Yes.
Dawn What makes getting a job so important?
Gabriel The extra income would be nice for the family.
Dawn The extra income would be nice? Have a little extra spending money.
Gabriel Yes.
Dawn Do you think there are any other benefits to working part-time?
Gabriel Meeting new people.
Dawn Okay, so you’re ready to go out there and meet people, that’s great.
Gabriel Yeah.
Dawn Great. All of that sounds really good. So you’re pretty ready and it’s really important to you.
[Dawn shows Gabriel another piece of paper.]
Dawn Now, this is a different one. This is a “Confidence Ruler.” I want to know how confident you feel to be able to get a part-time job. With one is not at all confident and a ten is extremely confident. Where would you put yourself on this Confidence Ruler?
[Gabriel circles a number on the paper.]
Gabriel I would circle number four.
Dawn You’d circle number four, okay. So what makes you feel like it’s a four instead of a seven on confidence?
Gabriel Well, I haven’t worked in fifteen years.
Dawn Okay, so that makes you feel less confident?
Gabriel Yes.
Dawn What do you think would be difficult about working or about getting a job?
Gabriel I’m not computer savvy.
Dawn Okay, and yeah, all of the applications now are filled out on a computer, or most of them, so you’d need to get up to speed on that. Is there anything else you might not be so confident about?
Gabriel No.
Dawn That’s about it?
Gabriel Yes.
Dawn Okay. Why isn’t it a one? Why do you have some confidence that you can do this? That you can get a job?
Gabriel Well, I’ve always been a good worker.
Dawn You’ve always been a good worker? Good! Okay, well that’s good! So what we’re going to do is we’re going to help to boost your confidence because it seems like you’re ready and it’s important. We’re going to try to move this four maybe higher so you can feel better about trying to get a job.
Gabriel Okay.
[Dawn shows Gabriel another piece of paper.]
Dawn So one of the things that we do is we have this sample job application and it asks a bunch of questions that you’re going to need to know the answers to really quickly if you’re going to fill out an application online or if you’re going to write down on an application all of this information, so you need to have it handy. So it just puts everything all in one place. It might seem like you know your name, but you’ll be surprised by some of the questions so it’s important that you collect all of this information and have it with you when you’re ready to apply. So let’s start at the beginning. Does this sound okay to you?
Gabriel Yes, of course.
Dawn Does it sound like something you want to do?
Gabriel Yes.
Dawn Okay, so we can start by you filling out your name and your telephone number, okay?
[Gabriel picks up the pen and begins filling out the form.]
Gabriel Okay.
Dawn Now, when you write your phone number, make sure it’s one where an employer could reach you. Some people put their home number but nobody answers their home phone anymore because they have a cell phone, so put the number that you’re most likely to answer, okay?
Gabriel Okay.
Dawn Now, do you have an email address?
Gabriel No.
Dawn Okay, so in order to do applications online, it’s really good if you have an email address so after we complete this, I’ll go get my laptop and we’ll get you an email so you’ll be able to check your email in case employers respond that way to you. A lot of people prefer communicating by email now.
Gabriel Okay.
Dawn So we’ll get that taken care of. So now write down your current address.
[Gabriel does so.]
Dawn Now, it’s going to ask you on an application sometimes, “Do you want temporary work?” What that means is work around the holidays like the winter holidays are coming and a lot of people buy things for Christmas or Hanukkah and so they hire a lot of workers at retail stores during that time, and so would you want that kind of temporary work or do you want a part-time job that you could keep for a long time like all year?
Gabriel Just temporary work.
Dawn You like temporary for now?
Gabriel Yes.
Dawn I think that that’s a good idea. I know that you’re volunteering but this will be one more step in that direction, so that’s good.
Gabriel Okay.
Dawn So select the “yes” for temporary work and then I want you to think about what days and hours you would be available to work. Do you think that your thinking is better in the morning or is it better more in the afternoon or in the evening?
Gabriel It’s better in the evening.
Dawn It’s better in the evening. So you think better in the evening. So what kind of hours do you think you’d like to work, then?
Gabriel From seven to eleven.
Dawn From seven to eleven, okay. So write that down, down here that you’d be available to work from seven to eleven. So you’re going to be an evening kind of person.
Gabriel Yes.
Dawn Okay. An employer is going to ask you when you’re going to be able to start work so when do you think you’ll be ready to start?
Gabriel I’ll be ready as soon as possible.
Dawn Okay, so you can just put that down there.
Gabriel Okay.
Dawn That’s a good answer. It makes you sound ready and like you’ll really be a go-getter.
Gabriel An eager beaver.
Dawn Yup, yup. Okay, now this is the part of the sample application where you record your employment history. You mentioned that you last worked on a regular job fifteen years ago. And where was that?
Gabriel At a Dairy Queen.
Dawn At a Dairy Queen. Oh, the one right down the corner?
Gabriel Yes.
Dawn Okay, great. Write down Dairy Queen. Do you remember your supervisor?
Gabriel Yes.
Dawn So you can write his name there. Does he still work there, by any chance?
Gabriel I believe so.
Dawn Oh, wow. He’s been working there a long time, right?
Gabriel Oh yeah.
Dawn Because they may call him for a reference, but it’s been a long time so I’m not sure about that. Now, do you know the phone number of Dairy Queen?
Gabriel Yes.
Dawn You remember the phone number?
Gabriel Oh yeah.
Dawn That’s pretty good. Alright, Gabriel, you’ve done a really good job of filling out this application. Now, when you apply for jobs, what you’re going to do is you’re going to keep this with you so whether you’re doing it online or you’re doing it on paper, you’ll have all the information that you need, okay?
Gabriel Okay.
Dawn What we’re going to do in a few minutes is we’re going to go out minutes and get my laptop and we’ll get you an email address and show you how to check it in case prospective employers want to communicate with you by email, okay? And the next time that I come, in order to build your confidence some more, what we’re going to do is some mock interviews where we’re going to pretend that you’re at a job interview and you’re going to practice how you’d answer some of the questions that the employer might ask you. How does that sound?
Gabriel That sounds great. Wonderful.
Dawn Good. Alright, so let’s go out and get the laptop and get you an email.
[The screen fades to black. Upbeat music starts playing as the screen fades in to show Gabriel swinging on a porch swing outside and smoking a cigarette. The credits roll: Executive Producers: Dawn I. Velligan, PhD Natalie Maples Aguilar, MS Director/Editor: Robert Merrill Camera Operation: Lester Rosebrock The UT Health Science Center at San Antonio Department of Psychiatry Division of Schizophrenia and Related Disorders]