Background: Cognitive remediation is a behavioural intervention that aims to improve cognitive functioning with the goal of durability and generalisation. Although evidence suggests that computer-assisted cognitive remediation (CACR) improves cognitive functioning in individuals with schizophrenia, it remains unclear whether these effects generalise and lead to improvements in clinical symptoms and psychosocial functioning. The current study aimed to investigate the effects of CACR on clinical symptoms, cognitive functioning and psychosocial functioning in individuals with schizophrenia or schizoaffective disorder. Method: A systematic review was performed using the quality assessment criteria defined by Scottish Intercollegiate Guidelines Network (SIGN 50) to investigate the effects of CACR on clinical symptoms in individuals with a diagnosis of schizophrenia or schizoaffective disorder. Additionally, a within subjects repeated measures design was used to investigate the effects of CACR on cognitive functioning, functional capacity and everyday social functioning. Results: There was some evidence to suggest that CACR improves clinical symptoms, but the majority of studies reviewed did not report a significant effect, and a number of methodological weaknesses were identified in the literature. Results of the experimental study revealed improvements in speed of processing, reasoning and problem solving and the overall composite score for cognition, but these improvements could not be attributed solely to the CACR intervention. No improvements in functional capacity or everyday social functioning were observed. Conclusions: Further, more rigorous research is required to develop a clearer understanding of the effects of CACR on clinical symptoms. The results of the experimental study support previous literature which has identified that a pure CACR intervention does not improve psychosocial functioning. The results are discussed in relation to the relevant literature.

Objectives: To evaluate the effectiveness of cognitive rehabilitation therapy with patients with schizophrenia within a forensic population. The intervention aimed to improve domains of cognitive functioning which have been found to be impaired as a result of schizophrenia. Forensic patients with schizophrenia have been found to have greater impairments in cognitive functioning relative to non-violent patients. Therefore interventions which target these deficits are important in rehabilitation interventions. Design: A within subject repeated design was used. A control measure was also implemented which involved patients being used as their own control. Method: 17 participants successfully completed the cognitive rehabilitation intervention. Initially 23 participants were recruited. Participants received approximately five hours of the computer-assisted cognitive remediation administered over seven weekly sessions. Outcome measures were cognitive assessments measuring executive functioning, attention, verbal learning and memory, perceptual organisation and visual memory. Outcome measures were administered pre-intervention, during treatment, post treatment and at three months follow up. A control assessment was also administered prior to the commencement of the intervention. Results: Post treatment measures on attention, perceptual organisation, visual memory and aspects of executive functioning were found to be significantly improved in comparison to pre intervention and control assessments. At 3 month follow up these improvements in cognitive functioning were found to be sustained. Conclusion: The pilot study indicated that cognitive rehabilitations are effective in improving cognitive functioning within forensic populations with schizophrenia. These results have the potential to improve functional outcomes and recovery, which could indirectly improve symptoms and risk of future violence. Further research is required in this area to provide additional evidence for this intervention to be available to forensic patients with schizophrenia.