Cognitive Remediation Therapy (CRT)

Cognitive remediation therapy (CRT) is a set of techniques designed to teach ‘thinking skills’ and can be thought of as a form of cognitive rehabilitation. It involves training in a set of tasks designed to improve cognitive abilities and social functioning. The domains targeted depend upon client need, but might include attention, working memory, planning, and executive function. CRT has been studied most often in schizophrenia/psychosis, but also in other conditions such as anorexia nervosa. Patients with schizophrenia show cognitive deficits in executive functioning, verbal fluency, and distractibility (Wykes & van der Gaag, 2001). Patients with anorexia nervosa have difficulties in set shifting tasks which is believed to correspond to cognitive inflexibility / rigid thinking seen in this client group (Tchanturia, Davies, & Campbell, 2007).

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Presentations

  • Cognitive remediation work in anorexia nervosa | Tchanturia | 2017
  • Developing CIRCuiTS – pros and cons for service users, clinicians and researchers | Reeder | 2012
  • Enriching life skills through cognitive enhancement therapy | Franczak, Lippy, Meek, Chern, Miller | 2017

Treatment Guide

  • Cognitive Remediation Therapy For Anorexia Nervosa (Treatment Manual) | Tchanturia, Davies, Reeder, Sykes | 2010
  • The Cognitive Remediation Therapy (CRT) Resource Pack for Children and Adolescents with Feeding and Eating Disorders | Camilla Lindvall Dahlgren, Betteke Maria van Noort & Bryan Lask | 2015
  • UaB Home stimulation program | Tom Novack, Jacqueline Blankenship | 2002
  • Group cognitive remediation therapy for adolescents with anorexia nervosa: The flexible thinking group | Maiden, Baker, Espie, Simic, Tchanturia | 2014

Websites

Recommended Reading

  • McGurk, S. R., Twamley, E. W., Sitzer, D. I., McHugo, G. J., & Mueser, K. T. (2007). A meta-analysis of cognitive remediation in schizophrenia. American Journal of Psychiatry, 164(12), 1791-1802
  • Tchanturia, K., Lounes, N., & Holttum, S. (2014). Cognitive remediation in anorexia nervosa and related conditions: a systematic review. European Eating Disorders Review, 22(6), 454-462
  • Tchanturia, K., Doris, E., Mountford, V., & Fleming, C. (2015). Cognitive Remediation and Emotion Skills Training (CREST) for anorexia nervosa in individual format: self-reported outcomes. BMC psychiatry, 15(1), 53.
  • Wykes, T., & van der Gaag, M. (2001). Is it time to develop a new cognitive therapy for psychosis—cognitive remediation therapy (CRT)?. Clinical psychology review, 21(8), 1227-1256

What is Cognitive Remediation?

Components of CRT Programs

Wykes and van der Gaag (2001) categorize some of the components and features of CRT programs.
Type of interventionShaping behavior through reinforcementChanging the environmentPractice aloneDyadic teachingScaffolding
Target of interventionSpecific task performanceSpecific cognitive strategy (e.g., use of planning)
Type of outcomeNeuropsychological test performanceSocial functioningSymptom level
Medium of trainingIndividual treatmentGroup treatmentComputerized trainingPaper and pencil tasks

References

  • Tchanturia, K., Davies, H., & Campbell, I. C. (2007). Cognitive remediation therapy for patients with anorexia nervosa: preliminary findings. Annals of General Psychiatry, 6(1), art. 14. doi.org/10.1186/1744-859X-6-14

  • Wykes, T., & van der Gaag, M. (2001). Is it time to develop a new cognitive therapy for psychosis—cognitive remediation therapy (CRT)? Clinical Psychology Review, 21(8), 1227–1256.

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