Towards a tailored implementation program for tailored psychiatric rehabilitation: study protocol of a cluster randomized controlled trial for
Cognitive Adaptation Training (CAT) in people with Severe Mental Illness.

Background: Cognitive Adaptation Training (CAT) is a psychosocial intervention that focuses on reducing the negative effects of cognitive disorders, especially executive functions such as planning and targeted action. International research has shown that CAT enhances multiple aspects of daily
functioning in people with severe mental illnesses (SMI). Despite this evidence, implementation of the intervention into routine care remains a challenge. In this implementation research, a newly developed implementation program based on previous experience and scientific literature, is tested. Methods: To test the effectiveness of the implementation program, a multicenter cluster randomized controlled trial (RCT) will be conducted comparing the implementation program to a single training program in four mental health institutions in The Netherlands. Focus groups, semi-structured interviews and questionnaires are used at multiple levels of service delivery (service user; professional; team; organization) to identify factors that may hamper or facilitate implementation. The RE-AIM framework is applied to measure the effectiveness of the program. Following this framework, the primary outcomes are Reach, Effectiveness, Adoption, Implementation and Maintenance. These are assessed before (T0) during (T1) and after implementation (T2). The research has a total duration of 14 months, with a follow-up measurement (T3) at 14 months after baseline. Data will be analyzed using multilevel modeling. Discussion: This implementation research may provide important information about the implementation of psychosocial interventions in practice and may result in a program that is useful for CAT, and possibly for psychosocial interventions in general.

The teams in the intervention condition (implementation program) have implemented CAT better than the teams in de control condition.

0, 6, 12 months

Implementation program (intervention condition), no implementation program (control condition)