Can cognitive remediation therapy be delivered remotely? A review examining feasibility and acceptability of remote interventions

Jagtap, Shreya; Romanowska, Sylvia; Leibovitz, Talia; Onno, Karin A.; Burhan, Amer M.; Best, Michael W.

doi:10.1016/j.scog.2022.100238

Cited by 10 publications

(5 citation statements)

References 47 publications

(147 reference statements)

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“…Participants reported various treatment benefits, including enjoyment, added structure, achieving goals, and benefits lasting beyond therapy, including using cognitive strategies, metacognition, and cognitive skills more efficiently. These findings align with the emerging literature suggesting that remote CR is acceptable and beneficial (Gire et al, 2017;Jagtap et al, 2022). It was clear from the participants' accounts that having the therapist facilitate the sessions was a key component of success, as previously identified (Vita et al, 2021).…”

Section: Discussionsupporting

confidence: 85%

“…However, information on the acceptability of any intervention delivered remotely, especially from the service user's perspective, is limited. Despite recent reviews suggesting that remote CR provides clinical value with high retention rates (Gire et al, 2017;Jagtap et al, 2022), barriers remain. One which is prevalent in people with psychosis is a lack of digital literacy, skill and ownership (Robotham et al, 2016;Spanakis et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

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Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users

Parri,

Barret,

Hill

et al. 2024

Behav. Cogn. Psychother.

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Objectives: Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users’ views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods. Method: After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking. Results: The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist’s role, and (4) how it could be better. Conclusions: This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users

Parri,

Barret,

Hill

et al. 2024

Behav. Cogn. Psychother.

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“…While recent evidence suggests that CR interventions can also be delivered remotely, attrition rates appear to be very high, and more research is currently needed to confirm its effectiveness in this format: in-person treatment sessions currently represent the optimal standard [ 119 ].…”

Section: Psychosocial Interventionsmentioning

confidence: 99%

European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia

et al. 2022

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Background Although cognitive impairment is a core symptom of schizophrenia related to poorer outcomes in different functional domains, it still remains a major therapeutic challenge. To date, no comprehensive treatment guidelines for cognitive impairment in schizophrenia are implemented. Methods The aim of the present guidance paper is to provide a comprehensive meta-review of the current available evidence-based treatments for cognitive impairment in schizophrenia. The guidance is structured into three sections: pharmacological treatment, psychosocial interventions, and somatic treatments. Results Based on the reviewed evidence, this European Psychiatric Association guidance recommends an appropriate pharmacological management as a fundamental starting point in the treatment of cognitive impairment in schizophrenia. In particular, second-generation antipsychotics are recommended for their favorable cognitive profile compared to first-generation antipsychotics, although no clear superiority of a single second-generation antipsychotic has currently been found. Anticholinergic and benzodiazepine burdens should be kept to a minimum, considering the negative impact on cognitive functioning. Among psychosocial interventions, cognitive remediation and physical exercise are recommended for the treatment of cognitive impairment in schizophrenia. Noninvasive brain stimulation techniques could be taken into account as add-on therapy. Conclusions Overall, there is definitive progress in the field, but further research is needed to develop specific treatments for cognitive impairment in schizophrenia. The dissemination of this guidance paper may promote the development of shared guidelines concerning the treatment of cognitive functions in schizophrenia, with the purpose to improve the quality of care and to achieve recovery in this population.

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“…More RCTs are required to answer this question and to examine whether remote delivery might be effective. A review of RCTs for the treatment of obsessive-compulsive disorder (Jagtap et al, 2022) was able to identify the individuals for whom remote delivery was helpful, as well as to specify the therapeutic approach. Such a review for depressive disorders might provide useful insights.…”

Section: Discussionmentioning

confidence: 99%

The compassionate journey: An exploratory and controlled study assessing self‐compassion‐focussed mindfulness in a nonclinical sample

Yeshua

Zohar

2023

Couns and Psychother Res

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The purpose of the current study was to test a self‐compassion‐focussed mindfulness (SCFM) intervention for increasing self‐compassion and decreasing depressive symptoms, as well as to test the effect of initial self‐compassion as a possible moderator. Community volunteers participated in an SCFM group or in a control group and self‐reported at three points in time: at baseline (study, n = 73; control, n = 80), at the end of the 5‐week five‐session intervention (study, n = 57; control, n = 61) and at follow‐up 5 weeks later (study, n = 47; control, n = 50). The SCFM was a Hebrew adaptation based on a mindful self‐compassion programme, which is available online. The SCFM was held in person, in small groups (N < 20) over a 2‐month period. A four‐way interaction was found to be significant [F(2, 186) = 3.70, p = 0.027, η2p = 0.038]. Post hoc tests showed that those who were initially low on self‐compassion and participated in the SCFM experienced relief in their depressive symptoms and that their level of self‐compassion was increased. This implies that self‐compassion is a moderating trait, with the benefit of relieving suffering. By increasing the levels of self‐compassion in individuals, it is possible to improve their psychological health.

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Can cognitive remediation therapy be delivered remotely? A review examining feasibility and acceptability of remote interventions

Cited by 10 publications

References 47 publications

Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users

Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users

European Psychiatric Association guidance on treatment of cognitive impairment in schizophrenia

The compassionate journey: An exploratory and controlled study assessing self‐compassion‐focussed mindfulness in a nonclinical sample

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