Young people’s experience of individual cognitive remediation therapy (CRT) in an inpatient eating disorder service: a qualitative study

Giombini, Lucia; Nesbitt, Sophie; Waples, Lauren; Finazzi, Emilia; Easter, Abigail; Tchanturia, Kate

doi:10.1007/s40519-017-0369-x

Cited by 18 publications

(14 citation statements)

References 32 publications

(5 reference statements)

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“…This treatment aims to improve cognitive flexibility, in particular through repeated practice with skills such as set shifting, poor central coherence and attention to details [69]. At present, this treatment is being investigated for its potential to enhance efficacy with other evidence-based psychotherapy, such as cognitive behavioural therapy or the integrative model of psychotherapy commonly used in various clinical settings [41, 70, 71]. In our study, an integrative model of therapy including Neurocognitive Training appeared efficacious while all service users who underwent such treatment presented marked cognitive improvement.…”

Section: Discussionmentioning

confidence: 99%

The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy

et al. 2019

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BackgroundPatients with anorexia nervosa (AN) experience difficulties in neurocognitive functioning in the acute phase of illness which might be related to clinical presentation, but also in the apparently remitted state after weight recovery. Among the most commonly reported persistent deficits is cognitive inflexibility, which can be interpreted as a vulnerability trait or a “neuropsychological scar” reflecting the detrimental effect of prolonged semi-starvation in patients with a long duration of illness. Studies of adolescent samples with a relatively short clinical course may enable avoiding the effect of prolonged illness and help to determine whether neuropsychological deficits are trait or state dependent.The aim of this study is to assess cognitive functioning in adolescents with AN before and after the inpatient treatment programme, including cognitive remediation therapy (CRT).MethodsForty-seven adolescent female inpatients with AN diagnosed according to DSM-5 and fifty healthy female adolescents matched for the education level and age were recruited. The patients underwent a multimodal treatment including a ten-week CRT. The standardized and cross-validated neuropsychological (Trail Making Test – TMT A and B, Color-Word Stroop Task – CWST, Ruff Figural Fluency Test – RFFT) and clinical measurements (Beck Depression Inventory – BDI, Eating Attitude Test – EAT-26, Yale-Brown Obsessive Compulsive Scale – Y-BOCS) were used to assess both clinical (in the acute phase and after partial weight recovery) and control subjects.ResultsInitially, AN patients performed significantly worse compared to the controls, but afterwards, inpatient treatment improvement was noted on all examined measures. In a few subtests (TMT, CWST) performance of AN patients after the programme was still significantly poorer than in HC.ConclusionsCognitive inflexibility in adolescent AN patients, as measured with TMT, CWST, and RFFT tends to improve after therapy. Nevertheless, a few neuropsychological subtests which did not show complete normalization may warrant attention in subsequent studies. Further research including control intervention is needed to conclude whether CRT intervention affects the outcome.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1984-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy

et al. 2019

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“…Whilst a number of the case studies incorporated qualitative elements in the form of patient feedback forms, a recent large study specifically analysed patient feedback letters (n = 70) following individual CRT (Giombini et al, 2017). The majority of participants reported positive engagement in CRT and reflected that they had learned about thinking styles and problem solving strategies.…”

Section: Qualitative Studiesmentioning

confidence: 99%

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta‐analysis of the Literature

Tchanturia

Giombini

Leppänen

et al. 2017

Euro Eating Disorders Rev

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101

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Cognitive remediation therapy (CRT) for eating disorders has demonstrated promising findings in adult age groups, with randomised treatment trials and systematic reviews demonstrating medium to large effect sizes in improved cognitive performance. In recent years, several case series have been conducted for young people with anorexia nervosa, but these findings have not been synthesised in the form of a systematic review. This systematic review aimed to evaluate the evidence for the efficacy of CRT in child and adolescent age groups. Nine studies were identified, with a subsequent meta-analysis suggesting improvements in cognitive performance with small effect sizes. Patient feedback was positive, with low dropout rates. These findings suggest that CRT has potential as a supplementary treatment for young people with anorexia nervosa, warranting further investigation using randomised treatment trials. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

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“…Comparable to the current study, these patients also found it challenging when attempting to relate skills acquired in CRT to their everyday lives. A similar methodological approach, with comparable findings, was presented in a recently published study by Giombini et al [50]. In their qualitative appraisal of young peoples’ experience of individual CRT, only 13% (N = 9) of the patients were able to describe how they could use knowledge acquired during CRT sessions in their daily life.…”

Section: Discussionmentioning

confidence: 76%

Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa—Treatment Satisfaction and the Perception of Change

Dahlgren

Stedal

2017

Behavioral Sciences

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Cognitive remediation therapy (CRT) has recently been developed for children and adolescents with anorexia nervosa (AN). It focuses on decreasing rigid cognitions and behaviors, as well as increasing central coherence. Overall, CRT has been proven feasible for young individuals with AN, but little is known regarding the specifics of its feasibility, and the perception of change associated with the intervention. Consequently, the aim of the current study was to explore service users’ perspective on CRT with a specific focus on treatment delivery, treatment content, and perceived change. Twenty adolescents (age 13–18) with AN participated in a 10-session course of CRT. A 20-item treatment evaluation questionnaire was administered at the end of treatment, focusing on four aspects of the intervention: (1) general attitudes towards treatment, (2) treatment specifics, (3) the perception of change and (4) the patient-therapist relation. The main findings suggest high levels of treatment satisfaction, but somewhat limited perceptions of change. The current study is one of the most detailed accounts of adolescents’ perspective on CRT published on eating disorders, and highlights several important aspects of the treatment viewed through the eye of the receiver.

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Young people’s experience of individual cognitive remediation therapy (CRT) in an inpatient eating disorder service: a qualitative study

Cited by 18 publications

References 32 publications

The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy

The improvement in neurocognitive functioning in anorexia nervosa adolescents throughout the integrative model of psychotherapy including cognitive remediation therapy

Evidence for Cognitive Remediation Therapy in Young People with Anorexia Nervosa: Systematic Review and Meta‐analysis of the Literature

Cognitive Remediation Therapy for Adolescents with Anorexia Nervosa—Treatment Satisfaction and the Perception of Change

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