What is it about?
People with schizophrenia often experience cognitive difficulties (e.g., memory, attention) that greatly impact on their daily life. Yet, they remain poorly targeted by available treatment offerings. Cognitive remediation (CR) is a behavioural intervention that improves both neurocognition and functioning. Despite clinical guidelines for schizophrenia recommending CR, it is still not readily available in clinical services (access) and sizeable dropout rates have been reported (engagement). To elucidate the barriers and facilitators of CR access and engagement, we interviewed clinicians in Australia, in 2021. This study offers key insights into CR access, while recommending methods for optimizing its use in clinical services, to ultimately improve recovery outcomes of people diagnosed with schizophrenia.
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Why is it important?
Treatment offerings for cognitive health in schizophrenia are currently limited. Pharmacology has, so far, showed limited evidence for improvements in this area. Instead, CR is effective in improving both cognition and functioning with high-level evidence. It is important to fill the translational gap that persists for this therapy; i.e., it is time to apply research findings in clinical services, particularly considering the impact of cognitive difficulties in the daily lives of patients.
Perspectives
Cognitive remediation for schizophrenia does not seem to be utilized as often as it could be, in Australia, and around the world. This paper highlights different strategies to use this therapy more often and in an optimized way to potentiate consumer engagement. I believe that if this therapy was generalized across services and delivered within holistic psychosocial rehabilitation, the recovery outcomes of people with schizophrenia would significantly improve. When seeing that cognitive remediation has been researched for decades and that a potentially high proportion of people with schizophrenia have never even heard of it (Altman et al., 2023), this critically calls for efforts to improve its utilization. Reference: Altman, R. A. E., Tan, E. J., & Rossell, S. L. (2023). Access to cognitive remediation in Australia for people with schizophrenia. Schizophrenia Research. 256, 44-46. https://doi.org/10.1016/j.schres.2023.04.007
Dr Rosalie Ariane Eva Altman
University of the Sunshine Coast
Read the Original
This page is a summary of: Cognitive remediation for schizophrenia: Clinician perspectives on implementation barriers and facilitators., Rehabilitation Psychology, March 2024, American Psychological Association (APA),
DOI: 10.1037/rep0000552.
You can read the full text:
Resources
Accessing Cognitive Remediation in Australia
A CIRCuiTS blog post describing a related paper on access to cognitive remediation for people with schizophrenia.
Factors Impacting Access and Engagement of Cognitive Remediation Therapy for People with Schizophrenia: A Systematic Review
A systematic review investigating the use of cognitive remediation for schizophrenia.
Access to cognitive remediation in Australia for people with schizophrenia
A letter to the Editor published in Schizophrenia Research describing research conducted with people with schizophrenia living in Australia.
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