Journal article
Cognitive remediation for schizophrenia: Clinician perspectives on implementation barriers and facilitators
Rehabilitation Psychology, Vol.69(2), pp.171-183
2024
PMID: 38512182
Abstract
Neurocognitive deficits in schizophrenia have a major impact on functioning; however, they remain poorly targeted by available treatment offerings. Cognitive remediation (CR) is effective in improving neurocognition and functioning. Despite clinical guidelines for schizophrenia recommending CR, it is still not readily available in clinical services and sizeable attrition rates are reported in clinical trials.
To elucidate the barriers and facilitators of CR access and engagement, we conducted a mixed methods qualitative-dominant study with 12 clinicians in Australia, in 2021, with 1 hr interviews and additional rating scales completed.
Thematic analysis highlighted four themes (cognitive symptoms, CR intervention, motivation and engagement in CR, and CR implementation), and 14 subthemes. Clinicians emphasized the broad impact of cognitive deficits and outlined pros and cons of different CR approaches. Several factors were suggested as impacting engagement, including motivation assessments/techniques, neurocognitive insight, illness, and demographic factors. Lack of routine implementation in Australia was unanimously espoused and partly explained by a need for cost-effectiveness analyses, remote and flexible delivery, and increasing service resource provision and staff training in CR.
This study offers key insights into CR access, while recommending methods for optimizing CR implementation and dissemination to improve recovery outcomes of people diagnosed with schizophrenia.
Details
- Title
- Cognitive remediation for schizophrenia: Clinician perspectives on implementation barriers and facilitators
- Authors
- Rosalie Altman (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - PsychologyMaree Reser - Monash HealthEric Josiah Tan - Swinburne University of TechnologySusan Lee Rossell - Swinburne University of Technology
- Publication details
- Rehabilitation Psychology, Vol.69(2), pp.171-183
- Publisher
- American Psychological Association
- DOI
- 10.1037/rep0000552
- ISSN
- 1939-1544
- PMID
- 38512182
- Organisation Unit
- School of Health - Psychology
- Language
- English
- Record Identifier
- 991014497902621
- Output Type
- Journal article
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