by Rhiannon Murden, Assistant Psychologist & CIRCuiTS therapist involved in the ECLIPSE study
I thoroughly enjoyed delivering CRT using the CIRCuiTS programme. The programme is easy to use and deliver both as a therapist and for service-users to pick up. Working alongside service-users and offering support to consider how they approached tasks in order to develop new strategies and confidence in their abilities was really rewarding.
The programme provides prompts for service-users to reflect on their skills, appraise their strategies, and monitor goals progress. In addition, the programme allows space to reflect on how strategies developed using the programme could be applied to real-world tasks that people may struggle with. This helped to facilitate useful conversations between therapist and service-user. I think this was important in helping people to reach their goals.
Initially, I found it really important to encourage service-users to slow down and consider these prompts. When working independently, particularly early in therapy, there is a risk that people will rush through the tasks without this crucial reflection which helps develop metacognitive awareness and knowledge. Having a shared focus and thinking together about tasks helped build rapport and I think felt like a less threatening therapy context for some service-users. The programme is really engaging and feels more fun and less like a test than paper and pen exercises.
I think the programme allowed for individualised approach to therapy. There is a nice mix of tasks including tasks similar to things people may need to do in the real world such as planning a shopping trip or a journey. Despite service-users working through a similar programme of tasks, it provided opportunities for a really individualised therapy programme. The programme provided examples of strategies and space for people to include their own individual strategies. I think this really helped people to initially start thinking about what strategies may look like and encouraged them to think about those that they already use day-to-day which they might be able to implement to support other tasks.
The gradual increase in difficulty over time seemed to really help people build their skills and confidence and to develop a “menu” of personalised strategies that would help them as tasks became more challenging. The programme provides some really nice feedback which helps people recognise what they have achieved and was rewarding for them and me as a therapist to see.