Trial Implementation of CIRCuiTS Cognitive Remediation Therapy for People with Schizophrenia in Rural Australia: Therapists Experiences
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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.
KeywordsSchizophrenia Cognitive remediation therapy CIRCuiTS program Psychiatric rehabilitation Therapist experience
We would like to thank the patients and therapists who volunteered and worked on this trial. The CIRCuiTS therapy team in Orange, New South Wales (NSW), Australia included Jessica Apps (OT), Gill Leonard (SW), Jane Lumley (Psych), Carla Morgan (Clin Psych), Pieter Van Rensburg (Clin Psych), Kathleen Vigors (OT) and Yvette Black (OT). Special thanks to service managers Natalie Clarke, Timothy Hewitt, Lacey Healey, Helen McFarlane and Jason Crisp. Project partners included Prof. Kimberley Dean (NSW Forensic Mental Health Network), Robyn Murray (Pathways to Community Living Initiative) and Sue Bonar (Orange Community Mental Health). This project was supported by Round 1 funding from the NSW Ministry of Health’s Translational Research Grants Scheme (TRGS).
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