Cognitive strengths-based assessment and intervention in first-episode psychosis: A complementary approach to addressing functional recovery?. (July 2020)

• Record Type: Journal Article
• Authors: Allott, Kelly; Steele, Peter; Boyer, Frances; de Winter, Ashleigh; Bryce, Shayden; Alvarez-Jimenez, Mario; Phillips, Lisa
• Is Part Of: Clinical psychology review. Volume 79(2020)
• Publication Date: 2020-07
• Subjects: First-episode psychosis -- Strengths-based -- Cognition -- Motivation -- Well-being -- Personal recovery; Clinical psychology -- Periodicals; Psychology, Pathological -- Periodicals; Psychotherapy -- Periodicals; Psychology, Clinical -- Periodicals; Electronic journals; 616.89
• DOI: 10.1016/j.cpr.2020.101871
• Languages: English
• ISSNs: 0272-7358

Abstract

Abstract: People who have experienced psychosis describe functional and personal recovery as a key goal of treatment. To date, the early, pervasive and influential role of cognitive impairments in functional recovery in psychosis has been predominantly addressed using approaches aiming to remediate clinically-defined cognitive deficits. Despite acceptance of the recovery and strengths-based model of care for first-episode psychosis (FEP), there has been minimal attention paid to the potential for strengths-based approaches to be extended to cognitive function. The purpose of this review is to present the case for supplementary strengths-based approaches to addressing cognition and functioning in FEP. In this review we appraise current approaches to addressing cognition in FEP that have primarily focused on remediating cognitive impairment, showing evidence for inconsistent engagement and generally small treatment effects. We describe the important role of psychological factors such as motivation and self-efficacy in mediating the relationship between cognitive performance and functional outcome, and draw on positive psychology and self-determination theory as models for potential application in relation to a cognitive-strengths paradigm. Our review supports the argument for complementing approaches for remediating cognitive deficits by applying strengths-based or positive psychology approaches to the domain of cognition as a promising avenue for further enhancing personal and functional recovery from FEP. Highlights: Focusing on improving cognitive deficits may not always be engaging or effective in early psychosis. There has been minimal explicit focus on cognitive strengths in early psychosis. Cognitive strengths-based approaches may enhance wellbeing and recovery. Psychological factors such as motivation may be important mediators or recovery. Future research directions include validation and hypothesis-driven studies of cognitive strengths.