How Is Cognitive Remediation Used in Psychotherapy?

Cognitive remediation (CR) is a therapeutic approach that aims to address cognitive, neuropsychological, social and executive function in mental illness. To date, it has been examined mostly in cases of chronic psychosis, schizophrenia, and to a lesser degree, depression. The evidence on CR is positive and it has been shown to help reduce symptom severity and increase levels of functioning.

However, there is less evidence about its effectiveness on those with first episode psychosis or early depression. Additionally, it is unclear whether or not CR may benefit young people more or less than older individuals. The body of research on CR has expanded to include its validity with bipolar, obsessive-compulsive behavior, and other mental health conditions, but more work needs to be done.

R.S.C. Lee of the Clinical Research Unit at the Brain and Mind Research Institute of the University of Sydney in Australia wanted to expand the existing literature on CR to include younger individuals and more importantly, first episode treatment. To do this, Lee recruited 36 young adults with either first episode psychosis or depression and assigned them to CR or treatment as usual (TAU) for a period of 10 weeks.

The participants were assessed prior to entering treatment and again after they completed their sessions. Lee discovered that not only did CR improve learning and memory in the participants; it also resulted in significant gains in social and psychological functioning in all the participants. In other words, regardless of whether the participants had symptoms of psychosis or depression, those in the CR condition improved much more drastically than those in the TAU condition.

This is particularly important because psychosis and depression impair individuals in unique and different ways. Cognitive capacity, memory, executive function, and other domains are all affected differently depending on the psychological condition. However, based on the results of this study, CR is effective at improving all of those domains, despite the psychological condition impacting them.

Lee believes this study is just the first in a many that should be conducted on CR and its potential benefits for psychologically impaired individuals. Lee added, “Future studies need to examine this cohort further under more rigorously controlled conditions to provide more cogent evidence that CR should be incorporated into the standard treatment of psychiatric illnesses.”

Reference:
Lee, R. S. C., et al. (2013). Cognitive remediation improves memory and psychosocial functioning in first-episode psychiatric outpatients. Psychological Medicine 43.6 (2013): 1161-73. ProQuest. Web. 26 July 2013.

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  • billy

    billy

    August 24th, 2013 at 4:30 AM

    is there anyone who understands this a little more clearly than I did and who could tell me how this differs from other approaches because I am not sure that I got that from this article- thanks

  • NP

    NP

    August 25th, 2013 at 12:23 PM

    If this has worked for chronic psychosis there is no reason it would not work for a first episode.now the benefits could be very different.treatment that is administered during the first episode will definitely work better than after something had reached chronic levels.
    Hopefully this can help a lot more people that suffer a first episode of psychosis or depression.

  • Natalie Bush

    Natalie Bush

    August 26th, 2013 at 11:10 PM

    Social functioning can be a big deal when it comes to psychosis. You may have overcome the symptoms and the illness itself but getting back to ‘normalcy’ and interacting with other people can be a big challenge in itself.

    Hopefully cognitive remediation gains traction so as to enable so many individuals out there who need a helping hand to overcome not just symptoms but also in their social skills after the disorder has passed.

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