Feasibility and acceptability of cognitive adaptation training for first-episode psychosis

Cognitive and functioning impairments are present early in the course of psychotic disorder and remain one of the greatest treatment challenges. Cognitive adaptation training (CAT) is a compensatory approach to psychosocial intervention that is underpinned by a model that incorporates the role of cognition in daily functioning. CAT has established effectiveness in chronic schizophrenia but has received limited investigation in first-episode psychosis (FEP). The aim of this study was to examine the feasibility and acceptability of CAT in young people with FEP.

This was a single-arm feasibility study of CAT conducted at the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia. Five FEP participants received manually guided CAT from a fully trained CAT therapist. A range of feasibility and acceptability measures were recorded throughout the study, including participant and case manager satisfaction ratings.

All participants completed the CAT intervention and session attendance rates were very high (95.3%). Participants and their case managers indicated strong satisfaction with CAT as indicated by positive mean ratings on all satisfaction items, although there was a greater range in the participant ratings. Importantly, CAT did not have a negative effect on existing case management, with case managers reporting that CAT enhanced their treatment.

This study provides evidence that CAT is a highly feasible and acceptable intervention in FEP, which may be easily integrated within existing services. The effectiveness of CAT in improving functional outcomes in FEP is worthy of investigation in a larger trial.