Delivering Cognitive Remediation Remotely

by Lois Ann Parri, CIRCuiTS Technical Lead and Research Assistant at King's College London

Cognitive Remediation (CR), a well-established therapeutic approach, has shown great promise in alleviating cognitive challenges faced by individuals with psychosis. This condition often comes with significant cognitive impairments affecting people’s daily lives. However, the widespread implementation of CR remains a challenge. As a somewhat lesser-known treatment, services are not overflowing with CR therapists and specialists. To bridge this gap and extend its benefits to a broader population, researchers are exploring the potential of delivering CR remotely, aiming to evaluate its acceptability, feasibility, and benefits.

A recent study by King’s College London and NIHR South London and Maudsley (1) explored the viability and impact of remote therapist-supported CR for individuals living with psychosis. Beyond examining its acceptability and feasibility, the study estimated the cost implications and potential benefits for a comprehensive outlook on the potential of this alternative provision.

Twenty-nine people embarked on their CR journey, and although two discontinued, the average attendance was 25.5 sessions. This attendance rate shows that remote CR does not reduce engagement or adherence to therapy, which are fundamental for an adequate dose of mental health treatment. The post-therapy interviews emphasised the acceptability of remote CR and highlighted the perceived benefits (2), demonstrating the promise of this mode of therapy.

Perhaps the most important outcome was the substantial improvements in achieving goals as well as improved functioning, self-esteem, and cognition. These improvements offer individuals with psychosis hope especially for recovery. The results emphasise the potential effectiveness of remote CR, fuelling the conversation about its broader integration into mental health services and particularly, for adopting remote CR. The healthcare costs were similar to traditional face-to-face therapy, but had the advantage of a lower societal cost. This financial advantage highlights the efficiency of remote delivery, further underlining the case for its widespread adoption.

The conclusion of this study is that remote CR is a viable method of providing this therapy and may offer more convenience for some service users and therapists. However, there is one disadvantage, the issue of digital literacy and access to computer equipment and data. These barriers need a proactive approach before implementing therapy.

As we progress into an era where technology is seamlessly integrated into our daily lives, we should consider embracing and optimising the potential of remote CR that may hold one key to inclusive, accessible, and ultimately effective mental healthcare.

The full version of this paper is available to read and download for free at Cella M, Parri LA, Wang K, et al. Evaluating remote delivery of cognitive remediation in people with psychosis.

References

1) Cella, M., Parri, L., Wang, K., Quinn, R., Oyeleye, O., Jin, H., Wykes, T. (2024). Evaluating remote delivery of Cognitive Remediation in people with psychosis. Schizophrenia Research, 267, 367-372.

2) Parri, L., Barret, K., Hill, R., Hoque, A., Isok, I., Kenny, A., Markham, S., Oyeleye, N., Quinn, R., Sweeney, A., Wykes, T., Cella, M. (2024). Evaluating the acceptability of remote cognitive remediation from the perspective of psychosis service users. Behavioural and Cognitive Psychotherapy, 1-13.

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