Predictors of adherence to low support, computerised, cognitive remediation training in psychosis

Abstract

Aim: To 1) establish adherence rates to a computerised, low support cognitive remediation (CR) training programme and 2) delineate clinical, cognitive and psychological factors that predict adherence to CR.Method: A total of 48 participants with psychosis were asked to complete eight weeks of CR training following a comprehensive baseline assessment including clinical, cognitive and psychological factors. Rates of adherence were analysed and factors predicting adherence were established.Results: 54.4% of participants completed a meaningful amount of CR training (>300 min) and five key variables were observed to correlate with adherence: Full Scale IQ, age of onset of illness, positive symptoms (SAPS), therapeutic alliance (WAI) and computer literacy. WAI and SAPS were shown to be the most important of those factors; combined they explained 25.7% of variance in adherence, 20.1% of which was accounted for by WAI alone.Discussion: The current study provides a patient profile of those most likely to adhere to low-support CR. It also highlights the importance of the therapeutic alliance, despite the majority of training occurring in the absence of a therapist. As such, it may well be the quality of the alliance, and not the quantity of contact, that best predicts intervention adherence and success.