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Feasibility and tolerability of a cognitive remediation clinical service in first episode coordinated specialty care
Author(s) -
Lewandowski Kathryn E.
Publication year - 2021
Publication title -
early intervention in psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.087
H-Index - 45
eISSN - 1751-7893
pISSN - 1751-7885
DOI - 10.1111/eip.12978
Subject(s) - tolerability , cognitive remediation therapy , cognition , psychological intervention , medicine , psychology , psychiatry , clinical psychology , alternative medicine , pathology
Abstract Aim Cognitive remediation is an evidence‐based intervention targeting the common and disabling cognitive deficits in people with psychosis. Findings from efficacy studies and meta‐analyses show that cognitive remediation produces medium to large effects on cognition in both chronic and first episode patients. However, clinical availability of this treatment remains scarce, reflecting a major gap between science and practice. Here we describe the development of a cognitive remediation programme in an outpatient first episode psychosis clinical service, and preliminary feasibility and acceptability outcomes. Methods Based on evidence from efficacy trials and assessment within the clinic of perceived benefits and barriers, we developed a CR programme that involved both internet‐based computer training exercises and a weekly in‐person therapy group. Outcomes were assessed based on data from three consecutive 12‐week group series. Feasibility outcomes included adoption, fill, cost, and utilization; tolerability outcomes were based on user survey and focus group feedback. Results We found evidence of feasibility including good adoption, fill, utilization, and cost. We also found good tolerability and satisfaction based on feedback from a user survey and focus groups, with more than 80% of respondents reporting high overall satisfaction with the programme and subjective cognitive and functional improvements. Conclusions The present report provides preliminary evidence that cognitive remediation can be translated into real world clinical practice for first episode psychosis. Systematic evaluation of implementation and dissemination of cognitive remediation is needed, and has the potential to improve access to cognitive health interventions for people with psychosis.