Cognitive Remediation Therapy for People With Schizophrenia Spectrum Disorder: A Rapid Qualitative Review

Key Message

This rapid qualitative review analyzed 8 studies describing the perspectives of people living with schizophrenia spectrum disorder (SSD) who use cognitive remediation therapy (CRT), and their caregivers and clinicians. The aim of this rapid review was to identify experiences with accessing CRT, expectations of CRT for treating and supporting recovery from SSD, and experiences engaging with CRT. From the participant's perspective, this review found several perceived and realized benefits of CRT. People living with SSD reported notable improvements in their attention, memory, and problem solving. People living with SSD also reported improvement in their lives, when they applied the cognitive strategies acquired from CRT into daily life activities. People living with SSD also described improvement in communication skills, social engagement, motivation, independence, and a reduction in psychotic symptoms. This review found a common preference among people living with SSD and caregivers to provide personalized delivery and treatment of CRT. People living with SSD cited several ways to introduce personalized CRT: cognitive trainer or clinician's support and guidance; the content, design, and implementation of CRT; using technology; and group environment and interacting with peers. The constant presence of a polite, friendly, empathetic, and encouraging clinician contributed to beneficial views of CRT. People living with SSD enjoyed the structure of sessions and cognitive tasks, specifically working on tasks at their own pace with gradual increases in difficult that gave them a sense of accomplishment and mastery. People living with SSD also enjoyed using technology and playing games to complete tasks; however, some found accessing a computer and a high-quality internet connection difficult. Finally, while people living with SSD reported several social benefits to group-based CRT, others found group-based CRT to be unconducive for their learning, especially when the group environment was not supportive or encouraging. One study described caregiver experiences and another described clinician experiences. Caregivers and clinicians in both studies recognized the importance of matching the type of cognitive exercises and structure of sessions to the cognitive needs of people living with SSD. Furthermore, caregivers preferred more examples of real-life strategies that they can use to help their loved one apply in their daily life.