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Group cognitive remediation for schizophrenia: Exploring the role of therapist support and metacognition
Author(s) -
Cella Matteo,
Reeder Clare,
Wykes Til
Publication year - 2016
Publication title -
psychology and psychotherapy: theory, research and practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.102
H-Index - 62
eISSN - 2044-8341
pISSN - 1476-0835
DOI - 10.1111/papt.12062
Subject(s) - attendance , cognitive remediation therapy , cognition , psychology , schizophrenia (object oriented programming) , metacognition , clinical psychology , session (web analytics) , group psychotherapy , cognitive rehabilitation therapy , cognitive therapy , psychotherapist , psychiatry , world wide web , computer science , economic growth , economics
Objectives Cognitive remediation ( CR ) is a therapy targeting cognitive difficulties in psychiatric disorders. We recently develop a novel CR program for people with psychosis with a focus on metacognitive skills individually supported by a therapist. This study aims to assess the acceptability and feasibility of implementing CR in small groups where therapist support is shared amongst service users. Design Control group design with non‐randomized group allocation. Method Twenty‐five service users with a diagnosis of schizophrenia participated. Ten received group CR and 15 individual CR (i.e., one therapist for each service user). Both therapy formats were supported by one therapist. Participants were assessed before and after therapy with neuropsychological tests assessing different cognitive domains, self‐assessed cognitive complaints, and psychotic symptoms. Treatment satisfaction questionnaires and therapist's session ratings were also collected for group CR . Results Dropout rate was 20% for both methods. Session attendance was 74% for group CR and 86% for individual CR . Service users evaluated positively group CR and considered it helpful; therapists rated this delivery format feasible. Exploratory analysis suggested that the two methods have similar effects on cognition. After therapy, service users showed improvements in recall memory, reduced negative symptoms, and reported fewer cognitive complains. Conclusions It is feasible and acceptable for people with schizophrenia to take part in small CR therapy groups. The reduced therapist contact compared to individual therapy was well tolerated and may help sustain independent work. The small group format allows therapists to spend sufficient time to support the use of metacognitive strategies. Practitioner pointsCR small groups are feasible and acceptable for service users and therapists. Therapist support can be shared. Metacognitive‐based CR can improve cognition and may benefit awareness and negative symptoms.