The potential of a revised remote compensatory cognitive training for patients with schizophrenia

Background : Cognitive impairments in schizophrenia are strongly associated with decreased daily functioning and are a primary target of treatments. The effectiveness of cognitive remediation has been demonstrated; however, access is limited for individuals living in rural areas or those with difficulty commuting to treatment facilities. This study further refined a remote compensatory cognitive training (r-CCT), previously delivered with only the therapist participating remotely, to develop a fully remote version, the revised r-CCT (r-CCTR), enabling all participants to join from home or other locations. We examined its efficacy and feasibility. Methods : Patients with schizophrenia or schizoaffective disorder underwent r-CCTR (12 weeks, weekly 2-h sessions and 13 sessions, including a preparatory phase). Efficacy was assessed by evaluating cognitive function and clinical symptoms before and after the intervention. The primary analysis compared pre- and post-intervention scores among all participants. An exploratory analysis used mixed ANOVAs to compare the intervention group to a pre-intervention waitlist control group. Feasibility was assessed by examining whether the retention rate exceeded 50%. Results : Over 80% of participants completed r-CCTR and met feasibility criteria. Within-group pre–post comparisons revealed significant improvements in attention, learning and memory, and executive function, with moderate to large effect sizes ( d = .48–1.22). No significant changes were observed in non-target domains or psychotic symptoms. Exploratory analyses revealed significant group × time interactions in prospective memory, learning and memory, and executive function. Conclusions : r-CCTR is feasible in a fully remote setting and may improve specific cognitive functions in patients with schizophrenia. Future large-scale studies are warranted. Clinical trial number : Not applicable.