Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
South London & Maudsley NHS Foundation Trust, Maudsley Hospital, London, UK.
Behav Cogn Psychother. 2024 Sep;52(5):495-507. doi: 10.1017/S1352465824000109. Epub 2024 Feb 13.
Cognitive remediation (CR) can reduce the cognitive difficulties experienced by people with psychosis. Adapting CR to be delivered remotely provides new opportunities for extending its use. However, doing so requires further evaluation of its acceptability from service users' views. We evaluate the acceptability of therapist-supported remote CR from the perspectives of service users using participatory service user-centred methods.
After receiving 12 weeks of therapist-supported remote CR, service users were interviewed by a service user researcher following a semi-structured 18-question interview guide. Transcripts were analysed using reflexive thematic analysis with themes and codes further validated by a Lived Experience Advisory Panel and member checking.
The study recruited 26 participants, almost all of whom reported high acceptability of remote CR, and some suggested improvements. Four themes emerged: (1) perceived treatment benefits, (2) remote versus in-person therapy, (3) the therapist's role, and (4) how it could be better.
This study used comprehensive service user involvement methods. For some participants, technology use remained a challenge and addressing these difficulties detracted from the therapy experience. These outcomes align with existing research on remote therapy, suggesting that remote CR can expand choice and improve access to treatment for psychosis service users once barriers are addressed. Future use of remote CR should consider technology training and equipment provision to facilitate therapy for service users and therapists.
认知矫正（CR）可以减轻精神病患者的认知困难。将 CR 改编为远程提供，为扩大其使用提供了新的机会。然而，这样做需要从服务使用者的角度进一步评估其可接受性。我们使用参与式以服务使用者为中心的方法，从服务使用者的角度评估治疗师支持的远程 CR 的可接受性。
在接受了 12 周的治疗师支持的远程 CR 后，服务使用者由服务使用者研究人员根据半结构化的 18 个问题访谈指南进行访谈。使用反思性主题分析对转录本进行分析，主题和代码进一步由生活经验咨询小组和成员检查验证。
该研究招募了 26 名参与者，他们几乎都报告了远程 CR 的高度可接受性，并且有一些改进建议。出现了四个主题：（1）治疗效果感知，（2）远程与面对面治疗，（3）治疗师的角色，以及（4）如何改进。
本研究使用了全面的服务使用者参与方法。对于一些参与者来说，技术使用仍然是一个挑战，解决这些困难会影响治疗体验。这些结果与远程治疗的现有研究一致，表明一旦解决了障碍，远程 CR 可以为精神病服务使用者扩大选择并改善治疗的可及性。未来远程 CR 的使用应考虑技术培训和设备提供，以促进服务使用者和治疗师的治疗。
