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Application of errorless learning in schizophrenia
Published in Catherine Haslam, Roy P.C. Kessels, Errorless Learning in Neuropsychological Rehabilitation, 2018
In 2010, the Cognitive Remediation Experts Workshop emphasized the need to provide cognitive remediation therapy in schizophrenia, which they defined as “behavioural training based on interventions that aim to improve cognitive processes (attention, memory, executive function, social cognition or metacognition) with the goal of durability and generalization” (Wykes, Huddy, Cellard, McGurk & Czobor, 2011; p. 472). Durability refers to the sustainability of the effects of a therapy, and generalization concerns the extent to which a person transfers these skills to their daily life. Improvement in cognitive function is not only crucial to reduce the illness burden for patients, but also the care burden for their relatives. It has the potential to decrease the economic cost of schizophrenia through reducing the number and duration of institutional admissions (Green, 2007). It has also been argued that cognitive interventions can help to maintain the benefits of more front-line (i.e., medication) and other treatment, such as somatic therapies, or psychosocial intervention (McGurk, Twamley, Sitzer, McHugo & Mueser, 2007).
The person with an eating disorder
Published in Chambers Mary, Psychiatric and mental health nursing, 2017
Gillian Todd, Rosemary Marston
Service users can be taught to understand and manage their ‘attention to the negative’ thinking style, in different ways. One method of doing this is by using cognitive remediation therapy developed for eating disorders by Tchanturia and discussed in her 2014 paper.19 Simply put, this is training the brain to be flexible and to move from a detailed focus to ‘bigger picture’ thinking.
Psychosis, violence and crime
Published in John C. Gunn, Pamela J. Taylor, Forensic Psychiatry, 2014
Pamela J Taylor, Pamela J Taylor, Sue Estroff, Paul Mullen, Pamela J Taylor, Simon Wessely
This is not the place for an exhaustive examination of all possible psychosocial treatments relevant for people with schizophrenia. Some, such as social skills training, we would regard in some form as simply part of the overall context of (re)habilitation, whether or not the individual has offending as part of his/her cluster of problems. Cognitive remediation therapy for schizophrenia is a behavioural training based intervention that aims to improve cognitive processes (attention, memory, executive function, social cognition or metacognition) with the goals of durability and generalization. This reflects observations that impairments in cognition may affect longer term outcome, including social functions and patients’ concerns about the impact such deficits may have on their everyday lives. Given the findings that men who have psychosis and are also violent may have more structural and functional brain difficulties than those who have psychosis and no problems with violence, and, in turn, than healthy controls (see chapter 12), one might expect particular benefit from such treatment for people with psychosis who become offenders. It hardly needs saying, but there have been no studies with psychotic offender groups. A number of systematic reviews have suggested a general advantage for social function with cognitive remediation, but this finding was not consistent with two major dissenters (Dixon et al., 2009; NICE, 2009). This may arise partially from the different ways in which the training is delivered and partly from research methodology. Wykes et al. (2011) completed a systematic review and meta-analysis of all evaluations with a specified allocation procedure in the context of all participants receiving ‘standard care’, then allowing for sampling and other potential methodological biases. They identified 40 studies with, collectively, 2,014 participants. They found that cognitive remediation had a small to medium effect on both cognition and function, which was durable, with best effects obtained when the interventions were delivered at a time when the patients were clinically reasonably well and stable, and as part of a rehabilitation package rather than in isolation. There was no reference at all to violence or offending.
Cognitive remediation therapy for post-acute persistent cognitive deficits in COVID-19 survivors: A proof-of-concept study
Published in Neuropsychological Rehabilitation, 2023
Mariagrazia Palladini, Beatrice Bravi, Federica Colombo, Elisa Caselani, Camilla Di Pasquasio, Greta D’Orsi, Patrizia Rovere-Querini, Sara Poletti, Francesco Benedetti, Mario Gennaro Mazza
Cognitive remediation therapy (CRT) encompasses a wide range of therapeutic cognitive interventions targeting cognitive deficits to improve functional outcomes by reinforcing, strengthening, or reestablishing previous cognitive abilities (Kim et al., 2018). In this regard, CRT seems to reduce long-term cognitive impairment and the related social and psychological consequences (Medalia and Bowie, 2016), showing potential benefits in several neurological and psychiatric conditions with cognitive impairment similar to that observed in COVID-19 survivors (Cappa et al., 2005; Kim et al., 2018). Moreover, existing evidence reveals enhanced restorative effects of CRT when implemented in the framework of a metacognitive therapeutic approach on severe medical and psychiatric populations (Birnboim and Miller, 2004; Breitborde et al., 2017).
Effects of cognitive remediation therapy versus other interventions on cognitive functioning in schizophrenia inpatients
Published in Neuropsychological Rehabilitation, 2019
Magdalena Linke, Konrad S. Jankowski, Adam Wichniak, Marek Jarema, Til Wykes
Cognitive performance is an important contributor to recovery in schizophrenia as it is highly predictive of functioning (Green, 1996; Green, Kern, Braff, & Mintz, 2000) and is found across different phases of illness (Carrión et al., 2011; Horan et al., 2012). Cognitive impairment is also a better predictor of outcome in schizophrenia than psychotic symptoms (Milev, Ho, Arndt, & Andersen, 2005), and unfortunately antipsychotic medications have a very limited effect on cognitive performance (Keefe, Bilder, et al., 2007; Keefe, Sweeney, et al., 2007). In contrast, cognitive remediation therapy (CRT), a behavioural treatment, seems to have moderate effects on global cognitive functioning (effect size d = 0.45) and functional outcomes (0.42) (Kurtz, 2012; Wykes, Huddy, Cellard, McGurk, & Czobor, 2011). Results of all but one meta-analysis (Pilling et al., 2002) show that CRT has positive (although moderate) influence on cognition in individuals with schizophrenia (Grynszpan et al., 2011; McGurk, Twamley, Sitzer, McHugo, & Mueser, 2007; Wykes et al., 2011).
Donepezil and cognitive remediation therapy to augment treatment of alcohol use disorder related mild cognitive impairment (AUD-MCI): An open label pilot study with historical controls
Published in Substance Abuse, 2021
Morris D. Bell, Brian Pittman, Ismene Petrakis, Gihyun Yoon
Another approach to cognitive recovery is Cognitive Remediation Therapy (CRT). Recent research has suggested that CRT may improve attention, memory, and executive function in schizophrenia and related disorders.11–15 There is a small amount of research to suggest that CRT could improve neurocognition for patients with substance use disorders (SUDs).16–19 Our group demonstrated feasibility of CRT for outpatients with SUDs and found that CRT combined with Work Therapy (CRT + WT) led to greater improvements in several neurocognitive domains than Work Therapy (WT) alone. Moreover, AUD participants may have benefited more from CRT + WT than those with other SUDs.20 The study also found very high rates of recovery over 12 months (73%).