Trial Implementation of CIRCuiTS Cognitive Remediation Therapy for People with Schizophrenia in Rural Australia: Therapists Experiences

Abstract

Cognitive impairment which impacts on functioning in everyday tasks and quality of life affects many people diagnosed with schizophrenia. Cognitive remediation therapy (CRT) is recommended in the current Australian and New Zealand clinical practice guidelines for Schizophrenia and related disorders. An implementation trial of the Computerised Interactive Remediation of Cognition-Interactive Training for Schizophrenia (CIRCuiTS) program was undertaken in Orange, NSW, Australia. As an important component of the evaluation of the CIRCuiTS program in our local context, this study explored the meanings clinicians placed on their experiences as CIRCuiTS therapists. Seven CIRCuiTS therapists who were each involved in the implementation trial agreed to present platform papers at the CIRCuiTS Expo held in May 2018. A thematic analysis was undertaken on the transcripts of these presentations. Analyses showed therapists valued their involvement in delivering the CIRCuiTS program and pointed to many instances in which they felt their practice was enhanced. The three major themes identified from the data included (1) appreciation of the lived experience of schizophrenia, (2) the centrality of the therapeutic relationship, and (3) increased professional satisfaction and “Joy in work”. CIRCuiTS therapists’ language was consistent with recovery-focused practice. This was the first study to explore CIRCuiTS therapists’ experiences and occurred within a broader implementation trial. Overall, the findings supported the feasibility and acceptability of the CIRCuiTS program from the therapists’ perspective. Further research is required into the dynamics of the therapeutic relationship and contribution of CRT to the work-life experiences of clinicians providing psychiatric rehabilitation.