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Journal article
International expert perspectives on access, engagement, and implementation of cognitive remediation for schizophrenia: A Delphi study
Psychological Services, Vol.23(1), pp.22-30
2026
PMID: 39541545
Abstract
Cognitive remediation (CR) for schizophrenia has been extensively studied and has proven effective in improving both cognition and functioning. Yet, implementation into mental health services is poor, with implementation and engagement barriers and facilitators not understood. The present study aimed to assess expert opinions on CR barriers and facilitators that pertain to staff, mental health services, and consumers. Thirty-seven international CR experts (clinicians/researchers) responded to Likert-scale questions on implementation and engagement facilitators, essential CR components, barriers in mental health facilities, barriers for clinicians, and barriers for consumer access and engagement across three rounds of a Delphi survey. The main barriers to CR implementation were (a) lack of staff training, (b) lack of perceived relevance/lack of knowledge about cognitive deficits in schizophrenia and CR usefulness in both clinicians and consumers, as well as (c) lack of staff employed in cognitive rehabilitation roles. The presence of defeatist beliefs and difficulty in accessing the place of delivery were both barriers to consumer engagement and access. The most important facilitators for CR were a good therapeutic alliance, CR delivered as part of integrated rehabilitation services, psychoeducation provided to families and stakeholders, and CR focusing on generalization of learning to everyday life. This study highlights the barriers to CR implementation from experts. A multitude of factors were identified that need attention. It is also apparent that CR cost-effectiveness studies are needed to facilitate organizational change and national guideline recommendations for improving mental health services policy around serious mental illness/schizophrenia health care provisions.
Details
- Title
- International expert perspectives on access, engagement, and implementation of cognitive remediation for schizophrenia: A Delphi study
- Authors
- Rosalie Ariane Eva Altman (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - PsychologyEric Josiah Tan - Swinburne University of TechnologySusan Lee Rossell - Swinburne University of Technology
- Publication details
- Psychological Services, Vol.23(1), pp.22-30
- Publisher
- American Psychological Association
- Date published
- 2026
- DOI
- 10.1037/ser0000922
- ISSN
- 1939-148X; 1541-1559
- PMID
- 39541545
- Copyright note
- This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0; https://creativecommons.org/licenses/by/4.0). This license permits copying and redistributing the work in any medium or format, as well as adapting the material for any purpose, even commercially.
- Data Availability
- The data that support the findings of this study are available from the corresponding author, Rosalie Ariane Eva Altman, upon reasonable request.
- Grants
- Grant note
- This work was supported by the Swinburne University of Technology (Faculty Scholarship to Rosalie Ariane Eva Altman).
- Organisation Unit
- School of Health - Psychology
- Language
- English
- Record Identifier
- 991087098602621
- Output Type
- Journal article
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- Web Of Science research areas
- Psychology, Clinical
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