What common cognitive problems can Cognitive Remediation Therapy (CRT) address?

According to U.S. Department of Health and Human Services, “Cognitive impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their every day life.” Cognitive impairments frequently occur in people diagnosed with schizophrenia spectrum and other psychotic disorders. Common cognitive problems include difficulty paying attention, planning ahead, solving problems, learning and remembering information and responding rapidly to environmental demands. Cognitive impairments are related to a wide range of functional difficulties people with serious mental illness (SMI) experience, such as problems with social relationships, independent living skills, and employment.

Cognitive Remediation Therapy (CRT) has good empirical support and is designed to improve cognitive functioning through repeated practice of cognitive tasks and/or strategy training. Cognitive remediation involves the focused practice of thinking skill areas with the goal of improving weaknesses in these skills for people with mental illness. Problem areas in cognitive functioning may include difficulty with attention, concentration, memory, planning and organization, solving problems and slowed thinking speed. Attention affects the ability to focus on a task for any sustained period of time. Memory can impact acquisition, consolidation and retention of information and problem solving can affect reasoning, abstract thinking and planning.

Cognitive Remediation Therapy (CRT) can assist with the following areas:

1. Attention and concentration (e.g., difficulty paying attention, problems sustaining attention, “spacing out” or forgetting where someone is in a task)
2. Memory (e.g., not being able to recall a phone number, forgetting to do tasks, being unable to find needed items, forgetting to take medications)
3. Planning and organization (e.g., late or missed appointments, missed meals, difficulty keeping track of important documents)
4. Problem Solving (e.g., not completing tasks, difficulty prioritizing tasks, feeling overwhelmed, avoiding a task or person)
5. Thinking Speed (e.g., slow task completion, difficulty understanding what others are saying, slow verbal response time, unable to find words to express self)

For more information on the effectiveness of CRT, read this Meta-analysis of Cognitive Remediation in Schizophrenia.

Resources to implement CRT:

• There are several web-based cognitive training programs available to the public for a monthly charge or a modest annual fee. These programs include BrainHQ, Happy Neuron, and Lumosity.
• Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) is a well-developed compensatory approach to cognitive remediation that has been shown to be effective.
• SMI Adviser offers a free educational webinar on this topic: Compensatory Cognitive Training for Neuropsychiatric Conditions (March 2020).