Cognitive Enhancement Therapy in Early Schizophrenia: A Qualitative and Quantitative Case Series of Patients’ Experiences

Abstract

Evidence shows that cognitive remediation therapy improves cognition in individuals with schizophrenia. However, its broader impact on patients’ lives remains unclear. Furthermore, little is known about the motivational factors influencing treatment engagement. This quantitative and qualitative case series study identified factors that influence patients’ experiences while receiving cognitive enhancement therapy (CET). Nine individuals with schizophrenia who received CET completed two questionnaires and participated in semi-structured focus groups or in an individual interview about their experience with CET. Four deductive themes were assessed when analyzing responses: (1) perceived impact, (2) motivational facilitators, (3) motivational barriers, and (4) suggestions to improve CET. All participants reported that CET was helpful, and the majority enjoyed participating in CET. Most participants reported high satisfaction with their work and school, but lower satisfaction with their social life. Results also indicated perceived improvements in negative symptoms, neurocognition, and confidence following CET. Participants identified extrinsic, intrinsic, and program-specific facilitators and barriers motivating their participation in the program. Suggestions to improve CET included changes to treatment design and content. Altogether, these results indicate that the perspective of CET end users can provide useful information on the factors influencing treatment engagement, satisfaction, and perceived impact.