Compensatory Interventions for Cognitive Impairments in Psychosis: A Systematic Review and Meta-Analysis

Allott, Kelly; van‐der‐EL, Kristi; Bryce, Shayden; Parrish, Emma M.; McGurk, Susan R.; Hetrick, Sarah; Bowie, Christopher R.; Kidd, Sean A.; Hamilton, Matthew; Killackey, Eóin; Velligan, Dawn I.

doi:10.1093/schbul/sbz134

Cited by 42 publications

(31 citation statements)

References 62 publications

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“…Integrated models of rehabilitation, such as the Boston Psychiatric Rehabilitation Approach [BPRA; (35)(36)(37)] and the Strengths model (38), provide tools to gain insight into and work toward recovery goals. Additionally, rehabilitation interventions that focus on recovery in specific (life)domains are available, ranging from cognitive remediation programs with a focus on functional impairment due to cognitive impairments [e.g., (39,40)], lifestyle interventions [e.g., (41,42)], and interventions aiming for recovery in the domain of work/school such as supported employment [e.g., (43)] or supported education programs [e.g., (44)]. In the last decade, user-led/user-developed interventions have gained increasing ground, such as Wellness Recovery and Action Planning [WRAP; (45)], "Recovery is up to you" (46), and Toward Recovery, Empowerment and Experiential Expertise (47).…”

Section: Introductionmentioning

confidence: 99%

Targeting Personal Recovery of People With Complex Mental Health Needs: The Development of a Psychosocial Intervention Through User-Centered Design

Meer

Jonker

Wadman³

et al. 2021

Front. Psychiatry

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Long-term admissions in psychiatric facilities often result in a gradual erosion of the identity of people diagnosed with severe mental illnesses (SMIs) into merely “patient.” Moreover, experiences of loss often reduced people's sense of purpose. Although regaining a multidimensional identity and a sense of purpose are essential for personal recovery, few interventions specifically address this, while at the same time take people's often considerable cognitive and communicative disabilities into consideration. This study describes the development process of a new intervention through user-centered design (UCD). UCD is an iterative process in which a product (in this case, an intervention) is developed in close cooperation with future users, such that the final product matches their needs. The design process included three phases: an analysis, design, and evaluation phase. In the analysis phase, the “problem” was defined, users' needs were identified, and design criteria were established. In the design phase, the collected information served as input to create a testable prototype using a process of design and redesign, in close collaboration with service users and other stakeholders. This resulted in an intervention entitled “This is Me” (TiM) in which service users, together with a self-chosen teammate, actively engage in new experiences on which they are prompted to reflect. Finally, in the evaluation phase, TiM was implemented and evaluated in a real-life setting. In a small feasibility pilot, we found indications that some people indeed demonstrated increased reflection on their identity during the intervention. Furthermore, TiM seemed to benefit the relationship between the service users and the mental health professionals with whom they underwent the experiences. The pilot also revealed some aspects of the (implementation of) TiM that can be improved. Overall, we conclude that UCD is a useful method for the development of a new psychosocial intervention. The method additionally increased our knowledge about necessary factors in targeting personal recovery for people with complex mental health needs. Moreover, we conclude that TiM is a promising tool for supporting people with SMI in redeveloping a multidimensional identity and a renewed sense of purpose.

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Section: Introductionmentioning

confidence: 99%

Targeting Personal Recovery of People With Complex Mental Health Needs: The Development of a Psychosocial Intervention Through User-Centered Design

Meer

Jonker

Wadman³

et al. 2021

Front. Psychiatry

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“…procedural memory) or by implementing environmental supports (i.e. alarm reminders, checklists) that sustain independent living and autonomy [12][13][14].…”

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confidence: 99%

“…Individualized cognitive remediation and concrete objectives on people's everyday complaints may be an effective alternative to obtain a meaningfully lasting transfer of training to daily life [15]. Importantly, it has been suggested that compensatory approaches are generally more e cient than restorative ones and more easily generalized to daily activities [14].…”

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confidence: 99%

“…Among the compensatory interventions that have been developed speci cally for schizophrenia (Twamley et al, ), the Cognitive Adaptation Training (CAT) [1,17] is the compensatory intervention that has received the most empirical support to date [14,18]. In this compensatory intervention, trained mental health specialists implement compensatory techniques such as environmental supports in the individual's environment to live more independently and achieve greater self-su ciency.…”

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confidence: 99%

“…In this compensatory intervention, trained mental health specialists implement compensatory techniques such as environmental supports in the individual's environment to live more independently and achieve greater self-su ciency. Several randomized controlled studies in chronic [1,14,[19][20][21] and rst episode psychosis [18,22] have established that the CAT intervention improves multiple outcomes at follow-up such as orientation, hygiene, but also adherence to treatment, relapse, and quality of life with high session attendance rates [18]. However, implementing this type of intervention can be time-consuming, requiring trained practitioners and time to maintain CAT effects.…”

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confidence: 99%

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Cognitive Remediation Program for Family Caregivers in Schizophrenia (CIRCUS): Study of the Effectiveness of a Guided AND WEB-BASED Compensatory Cognitive Remediation: A Randomized Pilot Study

Garbisson¹,

Laraki²,

Dubois³

et al. 2021

Preprint

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BackgroundCognitive impairments are extremely common in schizophrenia and strongly predict deficits in daily functioning, poor management of medication, and multiple hospitalizations. Cognitive remediation is recognized to have a positive impact on cognitive impairments by engaging preserved cognitive functions or by implementing environmental supports that sustain independent living.Velligan et al. [1] developed and tested a manualized intervention, called Cognitive Adaptation Training (CAT). In this program, trained mental health specialists implemented compensatory techniques such as environmental supports in the individual’s living environment in order to live more independently and achieve greater self-sufficiency.However, implementing this program requires a lot of professionals and time to maintain CAT effect. This type of intervention is not widely available in community care which may explain the large number of patients who are dependent on family members for daily living activities. Training family members in this form of intervention would be an appropriate way to resolve these issues. Family expressed a real interest in these types of home-support strategies that CAT offers. Recently, Kidd et al. [2] developed a CAT version for Families and created a manual accessible to people without any knowledge of cognitive deficits. This manual helps families to select specific cognitive-adaptative strategies with their relative to achieve targeted goals. This method has been translated in French.The aim of this study is to examine whether Web-based Family Cognitive Adaptation Training can improve functioning, medication adherence and negative symptoms for individuals with schizophrenia as well as reduce burden for the family members.Methods/DesignA total of 60 Dyads consisting of one caregiver and one supported individual with schizophrenia will be randomized to either Web-based family cognitive adaptation training or an internet-based control condition (psycho-education). The primary outcome measure will be the total score on the life skills profile. Secondary outcome measures will include the global score of the Zarit burden Interview, the PANSS negative score, the CAINS score, patient medication adherence, and patient and caregiver quality of life.DiscussionWe hope that this type of intervention could be developed in territorial areas where professionals are not trained to cognitive remediation and therefore substantially lower the barrier to the deployment of cognitive interventions with other psychosocial interventions for individuals with schizophrenia and their caregivers.Trial registration: ClinicalTrials.gov Identifier: NCT04173598. Registered on November 22th 2019

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An Update on Treatment of Cognitive Impairment Associated with Schizophrenia

Horan

Catalano

Green

2022

Current Topics in Behavioral Neurosciences

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Compensatory Interventions for Cognitive Impairments in Psychosis: A Systematic Review and Meta-Analysis

Cited by 42 publications

References 62 publications

Targeting Personal Recovery of People With Complex Mental Health Needs: The Development of a Psychosocial Intervention Through User-Centered Design

Targeting Personal Recovery of People With Complex Mental Health Needs: The Development of a Psychosocial Intervention Through User-Centered Design

Cognitive Remediation Program for Family Caregivers in Schizophrenia (CIRCUS): Study of the Effectiveness of a Guided AND WEB-BASED Compensatory Cognitive Remediation: A Randomized Pilot Study

An Update on Treatment of Cognitive Impairment Associated with Schizophrenia

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