Translating cognitive behavioral interventions from bench to bedside: The feasibility and acceptability of cognitive remediation in research as compared to clinical settings

Abstract

This comparison of CR in clinical and research sites highlights the decrease in referrals, enrollment and utilization that occurs when a program moves from a highly controlled setting to the real world. Still, the acceptability, fill rates and utilization indicated that CR can be successfully implemented in large scale, geographically diverse, publically funded clinic settings.

Cognitive remediation in large systems of psychiatric care

“…Consistent with guidelines for program evaluation in clinical settings, 41 , 42 outcomes include a client-completed satisfaction scale and a clinician report on recovery progress both completed after 30 sessions. The outcome questionnaires, as well as utilization data from Phase 1 were previously published, 43 and the addition of data from Phase 2 supported the perceived effectiveness of the treatment and high level of satisfaction with the program 44 …”

The synergistic benefits of physical and cognitive exercise in schizophrenia: Promoting motivation to enhance community effectiveness

“…Improving compliance and adherence also remain a significant concern in CT programs. Whereas laboratory-based evaluations of CT indicate efficacy along with high treatment compliance (with nearly all studies noting how participants were paid to attend treatment sessions, and with the standard practice of reminder calls and other outreach efforts to increase compliance), the real-world effectiveness of CT can be compromised by amotivation since patients are not paid to participate in CT offered as part of clinical care (Kremen et al, 2016; Medalia et al, 2019; Wykes and Spaulding, 2011). For example, a recent report of the effects of an intensive community outpatient psychosocial rehabilitation program for SCZ offering CT along with structured skills groups, such as social skills training, vocational counseling, and physical exercise, indicated that 37% of those enrolled (47 of 127) dropped out within the first month of treatment (Kurtz et al, 2015).…”

Employment, Studies and Feelings: Two to Nine Years After a Personalized Program of Cognitive Remediation in Psychiatric Patients

“…However, the vast majority of Research done around CR programs focused on internal validity rather than trying to extent findings on real world context (20). Recently, a CR program, called "Cognitive Remediation to Promote Recovery" (CR2PR), has been developed in 16 clinics in New York for patients with serious mental illness (21). The principle of CR2PR program insisted on the point that "cognitive remediation programs had to be delivered tied to overall recovery goals" to increase the impact on functional outcome (11,22).…”

“…Also, with an average number of 138 patients across the clinical sites, 40% of the users self-reported a high level of satisfaction with the service, and 96.9% qualified it as an excellent or good experience. Most patients found that CR improved cognition, and for 90% CR helped them to deal more effectively with situations at home, school, work, or with friends (21). Furthermore, Medalia et al (19), as well as Seccomandi et al (23) suggested to provide a "personalized medicine' with tailored medical intervention for CR, bringing an answer to the fact that around 25% of the patients do not improve after CR.…”

“…Also, with an average number of 138 patients across the clinical sites, 40% of the users self-reported a high level of satisfaction with the service, and 96.9% qualified it as an excellent or good experience. Most patients found that CR improved cognition, and for 90% CR helped them to deal more effectively with situations at home, school, work, or with friends ( 21 ). Furthermore, Medalia et al.…”