Cognitive Remediation Therapy: Improving Daily Functioning

Cognitive Remediation Therapy: Improving Daily Functioning

Cognitive[1] remediation therapy (CRT), is designed to improve neurocognitive abilities such as:

  • attention
  • working memory
  • organising, planning and information processing
  • executive functioning

The ultimate goal is to improve occupational performance in life domains of self-care, productivity and leisure.

Cognitive impairments such as attention and memory are prime causes of functional difficulty for people experiencing an enduring psychotic illness. It impacts on their ability to self-care contributing to poor physical health and social outcomes including employment and social participation

CRT is evidence-based practice designed to help people living with an enduring psychotic illness to improve cognitive ability and learn cognitive strategies to enable meaningful participation within their communities, including employment, living independently and engaging in social situations.  

What are we trying to achieve?

We wanted to understand whether Cognitive Remediation Therapy would improve the cognitive and daily functioning for eleven of their current service users living with an enduring psychotic illness.

What have we done?

A team of occupational therapists[2] and psychologists worked collaboratively to develope a trial Cognitive Remediation Programme that consisted of:

  • computer drill and practice sessions (three times a week for 24 weeks)
  • weekly session with an occupational therapist to coach strategies (24 weeks)

This programme was completed alongside a 16 week social cognition group.

Before and after completing this programme all participants had:

  • cognition testing undertaken by a psychologist
  • functional testing undertaken by an occupational therapist 

Additionally the team sought feedback from:

  • service users who participated in the programme
  • their family/whānau
  • their key workers
  • their community support workers
  • their therapist

Did we make a difference?

Nine out of the 11 services users completed the programme:

  • Validated testing, improvements were identified in attention and memory using validated testing
  • Functional gains were achieved primarily in:
    • Employment
    • Participation in activities of daily occupations
  • Three service users entered paid employment
  • Two were referred to an employment agency



Overall feedback indicated positive gains in:

  • social interaction
  • independence
  • use of mental health services in a more productive way

Where to from here?

There were clear significant gains from CRT trial programme, including improvement of cognition and overall improvements in function.

The team are working towards setting up the CRT programme as a regular intervention for service users within mental health services.


  1. Cognitive or cognition is the mental process of knowing, including aspects such as awareness, perception, reasoning, and judgment
  2. An occupational therapist works with a client to help them achieve a fulfilled and satisfied state in life through the use of "purposeful activity or interventions designed to achieve functional outcomes which promote health, prevent injury or disability and which develop, improve, sustain or restore the highest possible level of independence"
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