The use of implementation science to close the research-to-treatment gap for cognitive impairment in psychosis

Abstract

For people living with psychosis, cognitive impairment is common and can have significant impacts for functional recovery, impacting engagement with treatment and quality of life more broadly. There is now strong evidence for the effectiveness of cognition-focused treatments, such as cognitive remediation to improve clinical and functional outcomes for people with psychosis. However, engagement with treatment has been a long-standing issue in mental health care, including for people with psychosis, who often experience difficulties with motivation. While research on clinical effectiveness of cognition-focused treatment is growing, to date there has been little research focused on the implementation of such treatments and it is not clear how best to support uptake and engagement across diverse mental health settings. Implementation science is the study of methods and strategies to promote the adoption, application, and maintenance of evidence-based practices in routine care. To integrate cognition-focused treatments into routine practice, and improve engagement with treatment and the quality and effectiveness of care for people with psychosis, researchers need to embrace implementation science and research. This paper provides a succinct overview of the field of implementation science, current evidence for implementation of cognition-focused treatments for psychosis and practical guidance for using implementation science in clinical research. The future of psychosis research includes multidisciplinary teams of clinical researchers and implementation scientists, working together with providers and consumers to build the evidence that can improve the implementation of cognition-focused treatments.

Cognitive remediation therapy – implementation and translation into clinical practice in rural and metropolitan New South Wales mental health services

“…Zbukvic and colleagues 22 strongly advocate for the need for focused research to understand the most effective strategies for implementation of CRT in Australia. We agree and note that while the evidence for CRT as a psychosocial intervention is now well demonstrated, there is an urgent need for implementation research to develop the sustainable provision of CRT as a core feature of comprehensive public mental health rehabilitation programs across the state.…”