Effectiveness of Goal Management Training on Executive Functioning, Cognitive Complaints, and Everyday Functioning in Adults with Functional Cognitive Disorder: A Randomized Controlled Trial

Mohammad Reza Yekta; Salar Faramarzi; Zahra Khaleghzadegan; Zohre Alqasi

Authors

Mohammad Reza Yekta Postdoctoral Researcher in Neuropsychology, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran. Author https://orcid.org/0000-0002-2518-2950
Salar Faramarzi Professor in Department of Psychology and Education of Children with Special Needs, Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran. https://orcid.org/0000-0002-0493-9723
Zahra Khaleghzadegan M.A. in General Psychology, Department of Psychology, Isf.C., Islamic Azad University, Isfahan, Iran. Author https://orcid.org/0009-0002-4393-456X
Zohre Alqasi M.A. in Clinical Psychology, Department of Psychology, Khomeinishahr Branch, Islamic Azad University, Isfahan, Iran. Author https://orcid.org/0009-0008-1104-6537

Keywords:

functional cognitive disorder, goal management training, executive function, cognitive complaints, metacognition

Abstract

Purpose: This study aimed to evaluate the effectiveness of Goal Management Training (GMT) in improving executive functioning, cognitive complaints, and everyday functioning among adults with functional cognitive disorder (FCD).

Methods and Materials: This randomized controlled trial was conducted in 2026 at a specialist cognitive clinic in Isfahan, Iran. Sixty-four adults aged 25–60 years with clinician-confirmed FCD were randomly allocated in a 1:1 ratio to either GMT (n = 32) or an active Brain Health Education control condition (n = 32). The GMT group received nine weekly 120-minute sessions. Assessments were conducted at baseline, immediately after the intervention, and at 8-week follow-up. The primary outcome was executive functioning, assessed using the Global Executive Composite of the Behavior Rating Inventory of Executive Function–Adult Version (BRIEF-A). Secondary outcomes included cognitive complaints measured by the Cognitive Failures Questionnaire (CFQ) and everyday functioning assessed with the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Generalized estimating equations were used to test group-by-time interactions, with Holm adjustment for multiple comparisons.

Findings: Significant group-by-time interactions favored GMT for executive functioning at post-intervention (β = −7.54, 95% CI [−10.24, −4.84], adjusted p < .001, Hedges’ g = 1.37) and follow-up (β = −8.07, 95% CI [−11.25, −4.89], adjusted p < .001, g = 1.24). GMT also significantly reduced cognitive complaints at post-intervention (β = −4.59, 95% CI [−7.78, −1.40], adjusted p = .005, g = 0.68) and follow-up (β = −6.70, 95% CI [−9.87, −3.53], adjusted p < .001, g = 1.03). Everyday functioning similarly improved at post-intervention (β = −9.21, 95% CI [−12.79, −5.63], adjusted p < .001, g = 1.21) and follow-up (β = −6.51, 95% CI [−9.73, −3.30], adjusted p < .001, g = 0.98).

Conclusion: GMT was effective in improving executive functioning, reducing perceived cognitive failures, and enhancing everyday functioning in adults with FCD, with benefits maintained over an 8-week follow-up. These findings support GMT as a promising cognitive rehabilitation intervention for FCD, although larger multicenter trials with longer follow-up periods and objective ecological outcome measures are needed.

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