Computerised Interactive Remediation of Cognition and Thinking Skills

CIRCuiTS™ is fully compliant with the current UK General Data Protection Regulation (GDPR). No personal data about clients are stored anywhere on paper or electronically, and it is a requirement of therapists' use of CIRCuiTS™ that they comply with this. Our full Data and Privacy Policy is available on request, and there are resources in CIRCuiTS™ where clients and therapists can read about their data and rights.

The following book is an essential resource on the background, theory, and delivery of CRT: Wykes, T., & Reeder, C. (2005). Cognitive Remediation Therapy for Schizophrenia: Theory and Practice. Hove: Routledge.

Professor Dame Til Wykes Founder and Director Dr Matteo Cella NHS Clinical Lead & Training Dr Rumina Taylor Private Health Clinical Lead & Training Lois Parri Technical & Social Media Lead Rachael Constable Operations Manager

Yes it can. Check first that your client is comfortable using a tablet. CIRCuiTS™ provides both a client tutorial on using a touch screen and a therapist tutorial on delivering CIRCuiTS™ using a tablet. Please note that, as with a PC or laptop, an internet connection is required to use CIRCuiTS™ on a tablet. CIRCuiTS™ can be used on the following tablet devices:

No, it is not possible to use CIRCuiTS™ on any mobile phone device. Mobile screens are too small to view and interact with the finer details of CIRCuiTS™.

CIRCuiTS™ is a standalone piece of software which has been developed under the strict quality system of King's College London. It is a CE- and UKCA-marked Class I medical device. This means that it has been certified in accordance with the Medical Devices Directive 93/42/EEC and the UK Medical Devices Regulations (2002) The Medical Devices (Amendment etc.) (EU Exit) Regulations 2020.

CIRCuiTS™ is a psychological therapy which requires regular therapist supervision from someone with an understanding of Cognitive Remediation Therapy (CRT). For novices relatively new to therapeutic work, one-to-one supervision should be received weekly for a minimum of one hour from an experienced CIRCuiTS™ therapist. This can drop to fortnightly supervision after the first few clients. Where access to an experienced CIRCuiTS™ therapist is not possible, advice on supervision should be sought from a member of the CIRCuiTS™ team.

Cognitive remediation is a behavioural training intervention targeting cognition (attention, memory, executive function, social cognition, or metacognition), using scientific principles of learning, with the ultimate goal of improving functional outcomes. Its effectiveness is enhanced when provided in a context (formal or informal) that provides support and opportunity for extending to everyday functioning.

Evans, J., Tinch-Taylor, R., Csipke, E., Cella, M., Pickles, A., McCrone, P., ... & Wykes, T. (2023). Satisfaction with cognitive remediation therapy: its effects on implementation and outcomes using the cognitive remediation satisfaction scale. Schizophrenia, 9(1), 67. Tsapekos, D., Strawbridge, R., Cella, M., Goldsmith, K., Kalfas, M., Taylor, R. H., ... & Young, A. H. (2023). Cognitive Remediation in Bipolar (CRiB2): study protocol for a randomised controlled trial assessing efficacy and mechanisms of cognitive remediation therapy compared to treatment as usual. BMC psychiatry, 23(1), 1-14. Taylor, R., Crowther, A., Tinch‐Taylor, R., Lewin, C. D. C., Cali, C., Reeder, C., ... & Wykes, T. (2023). Evaluation of a new online cognitive remediation therapy (CIRCuiTS™) training for mental health professionals. Psychology and Psychotherapy: Theory, Research and Practice. Frawley, E., Heary, C., Berry, C., Cella, M., Fowler, D., Wykes, T., & Donohoe, G. (2023). Participant perspectives on cognitive remediation and social recovery in early psychosis (CReSt‐R): An acceptability study. Early Intervention in Psychiatry. Wykes, T., Stringer, D., Boadu, J., Tinch-Taylor, R., Csipke, E., Cella, M., ... & Joyce, E. M. (2023). Cognitive remediation works but how should we provide it? An adaptive randomized controlled trial of delivery methods using a patient nominated recovery outcome in first-episode participants. Schizophrenia Bulletin, 49(3), 614-625. Van Duin, D., Winter, L. D., Kroon, H., Veling, W., & van Weeghel, J. (2023). Associations between learning principles of cognitive remediation and cognitive and vocational outcomes in early psychosis—an exploratory analysis of RCT data. Applied Neuropsychology: Adult, 1-11. Frawley, E., Cowman, M., Cella, M., Cohen, D., Ryan, E., Hallahan, B., Bowie, C., McDonald, C., Fowler, D., Wykes, T., & Donohoe, G (2022). Cognitive Remediation and Social Recovery in Early Psychosis (CReSt-R): protocol for a pilot randomised controlled study. Pilot Feasibility Studies, 8, 109. Tsapekos, D., Strawbridge, R., Wykes, T., Young, A.H., & Cella, M. (2022). Cognitive remediation for people with bipolar disorder: The contribution of session attendance and therapy components to cognitive and functional outcomes. Journal of Psychiatric Research, 152, 144-151. Tsapekos, D., Strawbridge, R., Cella, M., Wykes, T., & Young, A.H. (2022). Towards personalizing cognitive remediation therapy: Examining moderators of response for euthymic people with bipolar disorder. Behaviour Research and Therapy, 151. Vita, A., Barlati, S., Ceraso, A., Deste, G., Nibbio, G., & Wykes, T. (2022). Acceptability of cognitive remediation for schizophrenia: A systematic review and meta-analysis of randomized controlled trials. Psychological Medicine, 1-11. Zhu, X., Fan, H., Zou, Y., Tan, Y., Yang, F., Wang, Z., Zhao, Y., Fan, F., Reeder, C., Zhou, D., Tan, S., & Wykes, T. (2022). Computerized or manual? Long term effects of cognitive remediation on schizophrenia. Schizophrenia Research, 239, 47-54. Tsapekos, D., Strawbridge, R., Cella, M., Young, A., & Wykes, T. (2021). Does cognitive improvement translate into functional changes? Exploring the transfer mechanisms of cognitive remediation therapy for euthymic people with bipolar disorder. Psychological Medicine, 1-9. Strawbridge, B., Tsapekos, D., Hodsoll, J., Mantingh, T., Yalin, N., McCrone, P., Kankam-Boadu, J. B., Macritchie, K., Cella, M., Reeder, C., Fish, J., Wykes, T., & Young, A. (2021). Cognitive Remediation Therapy for patients with bipolar disorder: A randomised proof-of-concept trial: CRT for bipolar disorders. Bipolar Disorders, 23(2), 198-208. Seccomandi, B., Agbedjro, D., Bell, M., Keefe, R.S.E., Keshavan, M., Galderisi, S., Fiszdon, J., Mucci, A., Cavallaro, R., Ojeda, N., Peña, J., Müller, D., Roder, V., Wykes, T., & Cella, M. (2021). Exploring the role of age as a moderator of cognitive remediation for people with schizophrenia. Schizophrenia Research, 228, 29-35. Van Duin, D., de Winter, L., Kroon, H., Veling, W., & van Weeghel, J. (2021) Effects of IPS plus cognitive remediation in early psychosis: 18-month functioning outcomes of a randomized controlled trial. Schizophrenia Research, 236, 115-122. Pothier, W., Roy, M., Corbière, M., Thibaudeau, É., Achim, A.M., Wykes, T., Reeder, C., Chagnon, Y., & Cellard, C. (2020). Personalized cognitive remediation therapy to facilitate return to work or to school in recent-onset psychosis. Neurocase, 26(6), 340-352. Dark, F., Newman, E., Gore-Jones, V., De Monte, V., Garrido, M.I., Dzafic, I. (2020). Randomised controlled trial of Compensatory Cognitive Training and a Computerised Cognitive Remediation programme. Trials, 21, 810. Palumbo, D., Mucci, A., Giordano, G. M., Piegari, G., Aiello, C., Pietrafesa, D., ... & Galderisi, S. (2019) The efficacy, feasibility and acceptability of a remotely accessible use of CIRCuiTS, a computerized cognitive remediation therapy program for schizophrenia: A pilot study. Neuropsychiatric Disease and Treatment, 15, 3103. Tsapekos, D., Taylor, R., & Cella, M. (2019) Feasibility and acceptability of brief cognitive remediation targeting metacognition in acute inpatients with psychosis: a case series. Neuropsychological Rehabilitation, 29(3), 361-375. Cella, M., & Wykes, T. (2019) The nuts and bolts of cognitive remediation: exploring how different training components relate to cognitive and functional gains. Schizophrenia Research, 203, 12-16. Thomas, M., & Rusten, K. (2019) Trial implementation of CIRCuiTS cognitive remediation therapy for people with schizophrenia in Orange, New South Wales. Australian Journal of Rural Health, 27(5), 463-468. Hyde, B., Thomas, M., Gullifer, J., & Dark, F. (2019) Trial implementation of CIRCuiTS cognitive remediation therapy for people with schizophrenia in rural Australia: Therapists experiences. Journal of Psychosocial Rehabilitation and Mental Health, 1-10. Hiekkala-Tiusanen, L., Halunen, M., Mehtälä, T., & Kieseppä, T. (2019) Psykososiaaliset menetelmät skitsofrenian hoidossa ja kuntoutuksessa-sivuosasta tähtinäyttelijäksi? [Psychosocial methods in the treatment and rehabilitation of schizophrenia-from an extra to a star actor?]. Duodecim, 135(20), 2011-2019. Wykes, T., Joyce, E., Velikonja, T., Watson, A., Aarons, G., Birchwood, M., ... & Greenwood, K. (2018) The CIRCuiTS study: Implementation of cognitive remediation into Early Intervention Services: A randomised controlled trial. Trials, 19(183). Allan, S., Cella, M., Wykes, T., & Perez, J. (2018) Cognitive remediation therapy for psychotic major depressive disorder. The Primary Care Companion for CNS Disorders, 20(3). Reeder, C., Huddy, V., Cella, M., Taylor, R., Greenwood, K., Landau, S., & Wykes, T. (2017) A new generation computerised metacognitive cognitive remediation programme for schizophrenia (CIRCuiTS): A randomised controlled trial. Psychological Medicine, 47(15), 2720-2730. Thibaudeau, É., Cellard, C., Reeder, C., Wykes, T., Ivers, H., Maziade, M., ... & Achim, A. M. (2017) Improving theory of mind in schizophrenia by targeting cognition and metacognition with computerized cognitive remediation: A multiple case study. Schizophrenia Research and Treatment, 7203871. Cellard, C., Reeder, C., Paradis-Giroux, A. A., Roy, M. A., Gilbert, E., Ivers, H., ... & Wykes, T. (2016) A feasibility study of a new computerised cognitive remediation for young adults with schizophrenia. Neuropsychological Rehabilitation, 26(3), 321-344. Reeder, C., Pile, V., Crawford, P., Cella, M., Rose, D., Wykes, T., ... & Callard, F. (2016) The feasibility and acceptability to service users of CIRCuiTS, a computerized cognitive remediation therapy programme for schizophrenia. Behavioural and Cognitive Psychotherapy, 44(3), 288-305. Cella, M., Reeder, C., & Wykes, T. (2016) Group cognitive remediation for schizophrenia: Exploring the role of therapist support and metacognition. Psychology and Psychotherapy: Theory, Research and Practice, 89(1), 1-14. Masson, M., Wykes, T., Maziade, M., Reeder, C., Gariépy, M. A., Roy, M. A., ... & Cellard, C. (2015) Top-down computerized cognitive remediation in schizophrenia: A case study of an individual with impairment in verbal fluency. Case Reports in Psychiatry, 242364. ​ Drake, R. J., Day, C. J., Picucci, R., Warburton, J., Larkin, W., Husain, N., ... & Marshall, M. (2014) A naturalistic, randomized, controlled trial combining cognitive remediation with cognitive–behavioural therapy after first-episode non-affective psychosis. Psychological Medicine, 44(9), 1889-1899.

The quotas of active clients (up to 20, 50, 200, etc.) mean the maximum number of clients that are allowed to be actively using/logging into CIRCuiTS™ in your organisation at any one time. Your organisation may work with as many clients as it likes within the license period, as long as the number of clients using CIRCuiTS™ simultaneously does not exceed the quota. When a client finishes CIRCuiTS™ their account should always be deactivated in the admin system, so that they are no longer counted towards your quota.

CIRCuiTS™ software is currently on version 3.6.1 and was last updated on Friday 7th June 2024. An additional update is planned for 8.30am (GMT) on Friday 29th November 2024. The deployment of the update is expected to take approximately 30 minutes.

An unlimited number of therapists (with suitable training and supervision) may use CIRCuiTS™ within an organisation that has purchased a license. However, the number of clients who are actively using CIRCuiTS™ within an organisation is restricted: see here.

Licenses may only be used for their purchased purpose. It is not possible to purchase a combined Clinical and Research license.

As soon as you like, provided that you are receiving regular, ongoing supervision from a suitable clinician. In fact, it is encouraged that you begin working with a client as soon as possible after completing the training, in order to consolidate your learning.

There are 11 online modules, each taking around 1-2 hours to complete. If purchasing our Online Training Package, you will have a maximum of 3 months access to CIRCuiTS™ to complete the training. We therefore recommend that you complete at least 1 module a week. The training can be challenging and time-intensive, and so it is important that you proactively set aside time in your work schedule to complete the modules, getting approval and support from your management if necessary. If your organisation is also purchasing a CIRCuiTS™ license (or already has one) you will be able to access CIRCuiTS™ for the duration of that license and therefore will have longer to complete the training.

The training features the following 11 modules: Module 1: Introduction to the Course and CRT Module 2: How to Use CIRCuiTS™ Module 3: Cognitive Targets Module 4: Metacognitive Knowledge Module 5: Metacognitive Regulation Module 6: Setting Goals and Motivation Module 7: Optimising Learning and Motivation Module 8: Selecting, Assessing and Formulation Module 9: Encouraging Independence and Transfer Module 10: Your Role as a Therapist Module 11: Getting Started with CIRCuiTS™

After completing the online course, in order to complete your training you may be required to attend a clinical workshop or to receive supervision from an experienced CIRCuiTS™ therapist (e.g. from within the CIRCuiTS™ team) on your first two clients. Supervision and face-to-face training arrangements should be discussed with the CIRCuiTS™ team at the point of purchasing the training.

No, the online training is currently only available in UK English. The CIRCuiTS™ programme itself, however, is available in a range of languages: see here.

Click the Members Forum page in the menu above. Enter your email and a strong password of your choosing, and click Sign Up. Keep Join this site’s community ticked in order to use the full range of forum functions. A sign-up request will be sent to the CIRCuiTS™ Team for approval. If you currently have an active CIRCuiTS™ account, your request will be approved and you will be notified of this by email. You will then be able to log into the Members Forum page (by clicking 'Log In').

Our Members Forum is accessed via this website. It is a place for CIRCuiTS™ trainees and practicing therapists to connect with other trainees and therapists around the world. Members have their own profile and can ask questions, start discussions and debates, offer advice, encouragement, and support, and share experiences (both difficulties and successes!). There is one forum area for practitioners and one for trainees. In the forums, members can search for, read and comment on questions and discussions that other members have started. Members can also write their own forum posts asking a new question or opening up a new topic for discussion. We hope that this will allow members to benefit from the wealth of knowledge and connection within the worldwide CIRCuiTS™ community.

The Members Forum is for people who already have an active CIRCuiTS™ account. This normally means people who are currently doing our online training course or people who are currently delivering CIRCuiTS™ to clients under an active clinical or research license. Please do not request access to the Members Forum if you do not currently have an active CIRCuiTS™ account, as your request will not be approved.