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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). Read more
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Intervention

  • Cognitive remediation for anorexia nervosa manual  download  archived copy
  • Group cognitive remediation therapy for adolescents with anorexia nervosa – the flexible thinking group  download  archived copy
  • The Cognitive Remediation Therapy (CRT) Resource Pack for Children and Adolescents with Feeding and Eating Disorders download  archived copy
  • UaB Home stimulation program  download  archived copy
  • CogSMART  download

Presentations

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

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  download
  • 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  download
  • 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  download
  • 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. download
  • 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 download  archived copy

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 intervention Shaping behavior through reinforcement

Changing the environment

Practice alone

Dyadic teaching

Scaffolding

Target of intervention Specific task performance

Specific cognitive strategy (e.g., use of planning)

Type of outcome Neuropsychological test performance

Social functioning

Symptom level

Medium of training Individual treatment

Group treatment

Computerized training

Paper 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.