Cognitive Remediation (CR) is an intervention focused on improving cognitive deficits, utilising a range of therapeutic activities and exercises designed to improve cognitive impairments.

It aims to improve cognitive functions like memory, attention, and problem-solving skills. CR has been found to be effective in addressing cognitive deficits associated with a range of mental health conditions, which include psychosis, bipolar disorder, and depression.

Early programs were initially developed to address the issues associated with brain injuries sustained by soldiers in World War I and World War II. As understanding of the roles of attention, memory, and problem-solving in everyday functioning grew, more comprehensive cognitive approaches emerged.

A more targeted and clinically focused approach began to take shape in the 1990s, with early developmental work by Hans Brenner and colleagues in Switzerland, and Ann Delahunty and Rodney Morice in Australia. Their contributions marked a shift from traditional, more holistic neuropsychological rehabilitation to interventions focused on specific cognitive skills.

This was followed by notable work by Alice Medalia, Gerry Hogarty, and Sam Flescher in the United States and Til Wykes in the UK. Coined for its emphasis on rectifying cognitive deficits, cognitive remediation (CR) was later refined by Til Wykes to incorporate strategies that enhance awareness of cognitive processes and support strategy use for learning and problem-solving. More recently, CR has been further expanded and applied to address cognitive factors that affect outcomes across a range of other psychiatric disorders.

CR can be delivered in a variety of formats, through individual or group therapy sessions, using paper-and-pencil or computer-based exercises, in person or completely remote. The approach can be tailored to meet the specific needs and goals of each person.

Clients will engage in targeted cognitive tasks and exercises designed to strengthen cognitive abilities, receive feedback on performance, and learn strategies to transfer gains to daily life. Therapists will guide clients through these exercises, monitor progress, facilitate metacognition, and adjust the therapy plan as needed.

Individuals seeking CR can access it through mental health services, hospitals, or private practitioners. Professionals interested in providing CR can receive training and certification through specific CR programs or accredited organisations. You can go to our programs page to find CR therapy programs that are developed or approved by CREW and its members.

It is grounded in extensive research and clinical practice and has been increasingly incorporated into mental health treatment plans worldwide. Furthermore, CR is endorsed and utilised by mental health professionals, and is included in treatment guidelines and recommendations by professional health organisations globally, including the American Psychological Association and the Department of Health and Welfare in Finland.

Concentration: The ability to focus your attention on one specific task or activity without getting distracted, such as when you are reading a book or talking to someone and not thinking about other things.

Short-term memory: The temporary storage of a limited amount of information for a short time in an active and readily available way. Short-term memory is used for things like remembering a phone number long enough to dial that number, putting the number in your mobile phone, or following directions someone just gave you a few minutes after receiving them.

Long-term memory: A relatively permanent storage system for information to be accessible for hours or even years. This includes facts you learned in school, instructions from your work supervisor, or remembering your childhood memories.
Learning and retention: This refers to your ability to learn information and be able to transfer it into long-term memory so that can be recalled at a later point. This is the capacity for how well and for how long individuals retain and remember knowledge, skills, or information acquired through learning.

Processing Speed: How quickly you can take in information and respond to that information to perform tasks. For example, how fast you can understand a question and formulate a response, recognise patterns, make decisions, and remember information.

Reasoning and problem solving: Reasoning is the ability to analyse the information needed to solve a problem, identify patterns in a situation and draw conclusions. Reasoning also involves drawing logical conclusions or inferences based on given information. Problem-solving is a broader process that includes reasoning as one of the steps towards a solution, which includes evaluating possible solutions.
Executive functioning: Executive functioning refers to the cognitive processes that enable you to plan, organise, adapt, and manage your actions and thoughts to achieve your goals. This area is often described as the "air traffic control" system, managing processes such as paying attention, remembering instructions, and tracking multiple tasks simultaneously.

Social cognition: Social cognition refers to the mental processes involved in understanding and responding to social information, including the ability to interpret others' behaviours, intentions, thoughts, and emotions. It includes reading facial expressions, understanding social cues, and knowing the appropriate social behaviours in different, and sometimes complex, social situations.

Overall, each of these cognitive and social cognitive functions work together to help us successfully navigate family, social, school, and work life, and each can be improved through participation in regular cognitive remediation programs.