Cognitive Remediation Therapy — MRCPsych Paper B MCQ

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ModerateRehabilitationCognitive Remediation TherapyMRCPsych Paper B

A 30-year-old woman with schizophrenia has stable positive symptoms but persistent difficulties with attention, working memory and processing speed that interfere with vocational rehabilitation. She begins a manualised programme involving repeated, graded computer-based exercises, strategy coaching and sessions that help her apply the strategies to shopping, travel and work. Which intervention is this?

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Correct answer: E — Cognitive remediation therapy

The intervention is cognitive remediation therapy. It uses structured, repeated practice and strategy coaching to improve neurocognitive functions such as attention, memory and processing speed. The additional work applying strategies to shopping, travel or employment is commonly termed bridging and aims to transfer cognitive gains into everyday functioning. CBTp primarily addresses distressing appraisals, beliefs and coping responses associated with psychotic experiences rather than directly training neurocognition. Social skills training rehearses interpersonal and communication behaviours, while family intervention works with the service user and relatives to improve communication, problem-solving and relapse prevention. Art therapy uses creative expression and is particularly considered for negative symptoms; it does not consist of graded cognitive exercises.

Reference: National Institute for Health and Care Excellence. Rehabilitation for adults with complex psychosis (NG181), recommendation 1.8.13 and Terms used: Cognitive remediation intervention. 2020. https://www.nice.org.uk/guidance/NG181/chapter/recommendations