Cognitive Remediation Therapy and Why It Is Helpful

What is cognitive remediation therapy?

Cognitive remediation therapy (CRT), also called cognitive enhancement therapy, helps improve cognitive skills in individuals. This is a form of cognitive rehabilitation that is especially beneficial for patients with mental health disorders causing cognitive impairment, such as schizophrenia, attention deficit hyperactivity disorder (ADHD), and traumatic brain injury.

During CRT sessions, individuals work with a therapist to complete exercises to enhance specific cognitive abilities. These exercises can be computer-based or paper-and-pencil, targeting attention, memory, problem-solving, and executive function.

In addition to cognitive remediation therapy exercises, CRT teaches strategies for managing cognitive symptoms. For instance, individuals with ADHD may learn to break down tasks into smaller, manageable steps, while those with schizophrenia might use memory notebooks to keep track of important information.

By combining CRT with other interventions and under the guidance of mental health professionals, individuals can access the necessary support, information, and care to nurture their overall well-being and lead fulfilling lives.

10 cognitive remediation therapy techniques

Cognitive remediation therapy can be a helpful treatment for people with cognitive impairment due to psychological disorders. This form of cognitive training can help people improve cognitive skills, functional skills, and quality of life. Here are examples of cognitive remediation therapy techniques:

1. Attention training

This training helps people improve their ability to focus and sustain attention. It may involve exercises such as following a moving object with the eyes or completing a task while ignoring distractions.

2. Working memory training

This cognitive remediation work helps people improve their ability to retain and manipulate information. It may involve exercises such as remembering a list of numbers or following a set of instructions.

3. Problem-solving training

This type of training helps people improve their ability to solve problems. It may involve exercises such as figuring out how to get from one place to another or how to put together a puzzle.

4. Executive function training

This type of training helps people improve their ability to plan, organize, and execute tasks. It may involve exercises such as setting goals, breaking down tasks into smaller steps, and managing time.

5. Visuospatial training

This training helps people improve their ability to perceive and understand the spatial relationships between objects. It may involve exercises such as drawing maps, assembling puzzles, or rotating objects in their mind.

6. Language training

This type of training helps people improve their ability to understand and use language. It may involve exercises such as reading comprehension, vocabulary building, or grammar drills, which can also help psychosocial functioning.

7. Memory training

This type of training helps people improve their ability to remember information. It may involve exercises such as recalling lists of words, remembering sequences of events, or remembering the steps involved in a task.

8. Attention shifting training 

This type of training helps people improve their ability to switch their attention from one task to another. It may involve exercises such as alternating between two tasks or attending to multiple stimuli simultaneously.

9. Inhibition training

This type of training helps people improve their ability to resist distractions and focus on the task at hand. It may involve exercises such as ignoring irrelevant information or suppressing impulses, such as in eating disorders.

10. Flanker task training 

This training helps people improve their ability to focus on the target stimulus and ignore distractors. It involves identifying a target stimulus among several distractors.

12 cognitive remediation therapy worksheets and exercises

These worksheets and exercises offer practical tools and strategies for attention, memory, problem-solving, executive functions, and more.

1. Block design

This task challenges individuals to replicate a given pattern using blocks, assessing their visual-spatial skills and ability to analyze and recreate complex designs.

2. Clock drawing

A Clock Drawing Test evaluates an individual's cognitive and motor skills by requiring them to draw a clock with accurate numbers, hands, and minute markers, testing their visuospatial abilities and attention to detail.

3. Visual puzzles

This task involves solving puzzles that rely on visual-spatial reasoning, requiring individuals to analyze and manipulate visual information to identify patterns, complete missing elements, or rearrange shapes.

4. Word fluency

In this task, individuals are prompted to generate as many words as possible, starting with a specific letter within a given time limit and assessing their verbal fluency and lexical retrieval abilities.

5. Sentence completion

This task involves completing given sentences with appropriate words and evaluating an individual's understanding of semantic and grammatical rules and their ability to express concepts accurately within a linguistic context.

6. Grammar drills

This task focuses on practicing and reinforcing grammar rules through exercises that target specific grammatical structures, helping individuals enhance their grammatical accuracy and language proficiency.

7. Word list learning

This task assesses an individual's ability to learn and remember a list of words and subsequently recall them from memory, evaluating their verbal learning and memory abilities.

8. Face-name memory

This task tests an individual's capacity to remember the names associated with specific faces, challenging their face-name association skills and ability to retrieve information from long-term memory.

9. Spatial memory

This task evaluates an individual's memory for the location of objects in space, measuring their ability to recall and reproduce spatial configurations accurately.

10. Switching tasks

This task assesses an individual's cognitive flexibility by requiring them to alternate between two different tasks or sets of instructions, measuring their capacity to switch attention, adapt, and shift between different mental processes.

11. Stroop task

This task involves identifying the color of a word while disregarding the word itself. For instance, the word "red" may be written in blue ink, and the objective is to identify the ink color rather than the word's meaning.

12. N-back task

This task entails remembering a stimulus sequence and identifying matches with the previous sequence. For example, a series of numbers is displayed, and the task is to recall the last number shown and determine if a newly presented number matches it.

When is it best to conduct cognitive remediation therapy?

Cognitive remediation therapy is typically conducted in the context of mental health treatment for individuals with cognitive impairments. Here are some situations where it is best to conduct a cognitive remediation program:

Following a neurological injury

CRT is often recommended after a brain injury, such as a stroke or traumatic brain injury, to help individuals regain cognitive functions that may have been impaired.

During the early stages of neurodegenerative diseases

CRT can benefit individuals diagnosed with neurodegenerative conditions like Alzheimer's disease or Parkinson's disease, particularly in the early stages when cognitive decline may be less severe.

Alongside psychiatric disorders

CRT is often an adjunctive treatment for individuals with psychiatric disorders such as schizophrenia or bipolar disorder, which can impact cognitive abilities. It aims to improve cognitive functioning and overall functioning in these individuals.

For individuals with attention deficits

CRT can be helpful for individuals with attention-deficit/hyperactivity disorder (ADHD) or other attention-related difficulties. It focuses on improving attention, concentration, and executive functions.

When cognitive impairments affect daily functioning

CRT is recommended when cognitive deficits significantly impact an individual's ability to perform daily tasks, work, or engage in social activities. It aims to enhance cognitive skills to improve overall functioning and quality of life.