Improving outcomes of cognitive behavioural therapy in the treatment of schizophrenia

Research on the effectiveness of cognitive behavioural therapy (CBT) in reducing the subjective impact of psychotic experience in individuals with schizophrenia is equivocal. Many studies report CBT to benefit individuals with schizophrenia in their management of residual symptoms, selfawareness and treatment adherence. However, only small to medium effect sizes are reported, and methodological limitations temper enthusiasm. LEWIS and RONAN suggest CBT outcomes in the treatment of schizophrenia can be enhanced through the application of neurocognitive remediation methods prior to CBT. Cognitive remediation therapy (CRT) is designed to remedy attention, memory and executive functioning deficits of neurocognitive functioning in schizophrenia through a process of individualised instruction and repeated exposure to relevant training tasks. Improvement of information processing capacity, declarative memory and task-related planning, sequencing and self-monitoring capacity can improve cognitive and social functioning, lessen vulnerability, and ‘prime’ the individual for a CBT and skills-based intervention.