Researchers at Orygen are exploring how implementation science can improve evidence-based practices that target cognitive functioning for people with psychosis.
Implementation science involves the study and application of different strategies and techniques to increase the likelihood that evidence-based treatments will be adopted and used in routine mental health care.
Cognitive functioning refers to a person's ability to think, reason, remember, and make decisions.
Dr Isabel Zbukvic, lead author of an opinion piece published in the Australian and New Zealand Journal of Psychiatry, said difficulties in thinking are common for people with psychosis and can make it hard for them to process information, communicate their ideas and problem solve to achieve optimal functioning in relationships, education, work, and life goals.
“Although there are treatments available to help with cognition, and more treatments are being developed, it's important to figure out how to use these treatments in the best and most efficient way.”
“Implementation science provides us with frameworks for understanding the barriers and facilitators to the uptake of new practices – in this case, treatments designed to improve cognitive and functional outcomes for people with psychosis – and for designing strategies to overcome these barriers,” Dr Zubkvic said.
“It involves looking at data and evidence to determine the best strategies and to evaluate how they are working, rather than just looking at how effective a treatment is.”
Implementation science considers different factors that could influence whether a treatment is successful, like the needs of people accessing care, the organisational culture at a service, and the processes and structures that support clinicians.
“This in turn can help services to determine which strategies will be the most effective for their context, workforce, and community,” Dr Zbukvic said.
“Research on how to best use treatments that target cognitive impairments in psychosis is limited and there is evidence that it can take years for evidence-based treatments to become part of routine mental health care.
“Implementation science speeds up the process by identifying ways to increase the use of evidence-based treatments such as training practitioners, providing incentives, or developing new organisational structures.”
Dr Zbukvic said we need more research to better understand what implementation strategies work best and in what contexts, and we need to include the perspectives of service providers and users in this work”.
“Researchers need to involve different stakeholders in the study of how to best implement treatments focused on cognition, including decision makers, those in charge of services, clinicians and other providers, and people living with psychosis and their families.
“By all working together, we can use this joint knowledge to help improve the delivery of care for psychosis and the outcomes for those living with it,” she said.