What is... psychology series

What is… Cognitive Remediation

graphic of a head with cogs turning inside

In this series, I dig a little deeper into the meaning of psychology-related terms.  This week’s term is cognitive remediation.

Cognitive remediation (CR) aims to improve psychosocial functioning by addressing several areas of neurocognitive functioning, such as attention, working memory, and executive functioning.

CR is used mostly in schizophrenia and traumatic brain injury.  It’s also been used in anorexia nervosa, where the focus is on improving metacognitive awareness of problematic thinking styles associated with the illness.

There are two types of strategies used in CR.  Compensatory strategies are aimed at developing workarounds for deficits, while restorative strategies promote the building of new neural connections in the brain through neuroplasticity.

A variety of information processing skills are taught, including verbalization, breaking a task into smaller steps, chunking, self-monitoring, using mnemonics, categorization, organization, and planning.  Some of the tasks include:

  • making change with the fewest number of coins possible
  • spotting the picture that doesn’t fit in a group of pictures
  • matching a picture to the one of a group it’s most similar to
  • word puzzles
  • complete a series based on the pattern shown
  • mental arithmetic
  • remembering information that was read 20 minutes before

There is computer software available for CR, but exercises can also be done on paper.  Work is also done with the therapist on bridging the skills learned into real life tasks that the individual would likely be faced with.

It’s usually run as a group, with 2 or more weekly sessions for 3-4 months.  There’s a Cognitive Remediation Therapy for Anorexia Nervosa group manual that has more details on that particular variation of CR.

In serious mental illness, CR has been shown to lead to improvements on standardized neuropsychological tests.  That improvement continued for 1-2 years.  In addition to improving cognitive functioning, it also improves social and occupational functioning.

CR has picked up steam in the area where I live over the last couple of years.  The concurrent disorders transitional program where I work runs a computer-based CR group.  I’ve never actually asked any of the clients what they thought of it.  I would guess that motivation would be an issue.  I’m all for exercising your brain, but I don’t know that I’d be keen on doing it in this particular way for 3-4 months.

I’m guessing that this is a more targeted version of some of the brain exercise programs that are aimed at the general public.  I’ve never tried any of them, but my uncle swears by Luminosity.

Have you ever tried cognitive remediation or any sort of brain exercise program?


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13 thoughts on “What is… Cognitive Remediation”

  1. Ashley, your posts are so beautifully written and professionally researched. Just wanted to thank you for all the work it must take to share your findings. Thank you. Cheers

  2. That does sound taxing if you think of it as exercising, because exercizing is so exhausting and requires so much will-power! I think my mom struggled after she “fell” down the stairs, because she suffered a TBI (among other things) and had to do a lot of therapy like that. I think it would be dreadful, so I’ve decided to never suffer a TBI. [Eyeroll. Like anyone can just decide that?] A lot of it too reminds me of when I worked at the reading center, and we’d have to review basic reading concepts again and again because the kids didn’t have solid grasps on the concept of, like, “oa” saying oh, or “ea” saying ee. Total repetitive practice and exposure to the concepts. Great blog post!!

  3. It’s not something I’d heard of, which doesn’t surprise me as I left mental health nursing some nine years ago. Cognitive remediation therapy (CRT) is not routinely available in our wonderful NHS so I have no experience of it.

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