Cognitive Remediation — MRCPsych Paper B MCQ

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ModerateRehabilitationCognitive RemediationMRCPsych Paper B

A rehabilitation service implements a programme in which patients with psychosis practise computerised exercises designed to improve attention, memory and executive function. A support worker then helps them apply the cognitive strategies they have learnt to real-world functional tasks. Which intervention is this?

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Correct answer: D — Cognitive remediation therapy

The answer is D, cognitive remediation therapy. It uses structured, usually manualised cognitive training to improve impaired domains such as attention, memory and executive functioning. The additional discriminating feature is the deliberate transfer or “bridging” of strategies learnt during exercises into everyday activities; this is intended to promote functional generalisation. Social skills training focuses on interpersonal behaviours and communication rather than neurocognitive performance. An occupational therapy skills programme directly practises daily activities but is not defined by systematic cognitive training. Individual Placement and Support aims to obtain competitive employment rapidly and provides ongoing employment support. Art therapy uses creative expression for therapeutic purposes rather than targeted remediation of cognitive deficits.

Reference: Lejeune JA, Northrop A, Kurtz MM. A Meta-analysis of Cognitive Remediation for Schizophrenia: Efficacy and the Role of Participant and Treatment Factors. Schizophrenia Bulletin. 2021;47(4):997–1006. https://pubmed.ncbi.nlm.nih.gov/33772310/