Cognitive Remediation Therapy Training Information Sheet

About Cognitive Remediation Therapy

Many people with a diagnosis of schizophrenia experience significant problems in concentration, memory, planning and problem-solving. They are frequently painfully aware of these problems and report that they prevent them from doing valued activities such as reading, watching TV or getting back to work. There is now also a large body of research evidence to suggest that cognitive difficulties are associated with poorer social functioning, quality of life, response to rehabilitation and work performance as well as higher dependence on psychiatric services. Therefore, if cognitive function can be improved then everyday performance and quality of life may also improve.

The CRT programme taught on this course is an individual psychological therapy which aims to improve cognitive functioning in people with a diagnosis of schizophrenia. In previous trials of the programme, people who received CRT made significantly greater improvements in memory and flexible thinking than people who received an alternative therapy based on occupational therapy activities. CRT also had a beneficial impact on self-esteem and cognitive improvements were associated with improved functioning in social situations. A study carried out by service-users found that the therapy was highly valued by participants, and that they reported noticeable improvements in their thinking skills.

CRT needs to be delivered intensively, taking place on most weekdays over three months. The course will help you to think about ways in which you can deliver CRT flexibly to fit in with your own service, for example by delivering CRT in group or helping patients to work independently at home. It targets concentration, memory, problem-solving, planning and metacognition and teaches people to develop strategies to overcome their difficulties. A variety of tasks are presented and repeated in each session, which are tailored to the individual to ensure that participants experience a high degree success and get lots of positive feedback.

Who can receive training?

The training is suitable for mental health professionals including for example assistant psychologists, clinical psychologists, occupational therapists, psychiatric nurses and psychiatrists.

Essential skills required by potential trainees:

1.  Ability to interact calmly and empathically with people with severe mental health problems.

2.  Ability to use psychological principles to inform interactions with others.

3.  Ability to motivate and engage people with severe mental health problems.

Course content

The course takes place over two days. It covers:

(a)  CRT research

(b)  the theoretical background to CRT

(c)  a model for the target cognitive skills and how they may relate to everyday living skills

(d)  the core skills needed to administer CRT

(e)  assessment

(f)  clinical issues in delivering CRT

(g)  service-related issues (e.g. the practicalities of therapy and how it may be accommodated within services).

It includes some teaching and live demonstration, video presentations, pair work (particularly to practice CRT tasks), group work and discussion. On the final day, each trainee has the opportunity to practice delivering CRT with a service user who is experienced in doing CRT, supervised by a CRT therapist. The aim is for trainees to gain enough working knowledge of CRT and to have had sufficient practice of CRT tasks to be able to begin therapy with clients under supervision.

There are usually about 15 trainees taking each course which is run by two or three trainers. Each trainee will receive a copy of the CRT manual and a Clinician’s Guide to CRT (Reeder and Wykes, 2002).

Useful References

Wykes T. and Reeder C. (2005). Cognitive Remediation Therapy: Theory and Practice. East Sussex, UK, Routledge.

WYKES T., HUDDY V., CELLARD C., MCGURK S.R. & CZOBOR P. (2011) A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. American Journal of Psychiatry, 168, 472-485

Contact

For further information, please contact Geraldine Davis on 020 7848 5040.