Background: Cognitive remediation (CR) is a psychological therapy, effective in improving cognitive performance and functioning in people with schizophrenia. As the therapy becomes more widely implemented within mental health services its longevity and uptake is likely to depend on its feasibility and acceptability to service users and clinicians. Aims: To assess the feasibility and acceptability of a new strategy-based computerized CR programme (CIRCuiTS) for people with psychosis. Method: Four studies were conducted using mixed methods. Perceptions of attractiveness, comprehensibility, acceptability and usability were assessed using self-report questionnaires in 34 non-clinical participants (study 1), and five people with a schizophrenia diagnosis and three experienced CR therapists (studies 2 and 3). The ease with which pre-specified therapy programmes could be assembled was also assessed by three therapists (Study 2). Finally, the satisfaction of 20 service users with a diagnosis of schizophrenia regarding their experience of using CIRCuiTS in the context of a course of the CR therapy was assessed in a qualitative interview study (study 4). Results: Ratings of perceived attractiveness, comprehensibility, acceptability and usability consistently exceeded pre-set high targets by non-clinical, clinical and therapist participants. Qualitative analysis of satisfaction with CIRCuiTS showed that receiving the therapy was generally seen to be a positive experience, leading to perceptions that cognitive functioning had improved and attempts to incorporate new strategy use into daily activities. Conclusions: CIRCuiTS demonstrates high acceptability and ease of use for both service users with a schizophrenia diagnosis and clinicians.

Borderline personality disorder (BPD) is associated with problems in attention, memory, planning and cognitive flexibility, which may underpin aspects of behavioural dysregulation. Cognitive remediation (CR) is an individual psychological therapy which aims to improve thinking skills and thus positively impact everyday functioning. We aimed to assess the feasibility and acceptability of CR for two BPD patients who had not previously engaged with psychological therapy. Participants were assessed using neuropsychological, symptom and social functioning measures and then received up to 40 sessions of individual CR. They were re-assessed post-therapy and 3 months later, and rated their experience of CR. The participants reported increased self-esteem and improved memory. Neuropsychological tests showed executive functioning improvements post-therapy, which were partially maintained at follow-up. CR was a feasible and acceptable therapeutic approach for these two participants and may hold promise as a complementary therapeutic approach for BPD characterized by marked cognitive problems or difficulty in engaging in more emotionally focused psychotherapies.

Background: Theories of the development of psychotic symptoms have suggested that metacognitive beliefs might play a part. However, studies offering supporting evidence have failed to distinguish between metacognitive beliefs about the consequences of having certain thoughts, and metacognitive beliefs about one's own cognitive skills. Aims: To distinguish metacognitive beliefs and investigate the extent of their association with psychotic-like experiences. Method: Participants were 60 healthy adults recruited primarily from two university campuses. Three measures of metacognition were administered: (i) Metacognitions Questionnaire (MCQ-30); (ii) Metacognitive Assessment Inventory; and (iii) Koriat General Questions Test; and two schizotypy questionnaires: O-Life and SPQ-B and data were analysed using an exploratory principal components analysis of the metacognition measures. Results: Three principal components were identified: (i) Beliefs about thoughts; (ii) Cognitive confidence; and (iii) Beliefs about cognitive regulation. Only the “beliefs about thoughts” component was significantly associated with the “psychotic-like experiences” factor, extracted from the measures of schizotypy. Conclusions: The finding supports theories suggesting that psychotic symptoms may be caused in part by negative metacognitive beliefs about thoughts. However, metacognition is a complex construct that is currently poorly understood.

It is important to ensure that the financial provision received by the long-stay psychiatric population is maintained as their care is relocated from hospitals to the community. A survey of the provision made by the 20 community homes to which Horton Hospital patients have been resettled was conducted. Comparison with the provision received by patients prior to resettlement revealed that the clothing allowance provided for patients without savings in Horton is often not maintained in the community and that resettled patients receive widely differing and frequently much smaller provision for clothing.