Cognitive remediation therapy in anorexia nervosa: implications for treatment developments and research trials

Though Cognitive Remediation Therapy (CRT) for anorexia nervosa shows promising evidence, questions remain regarding specific mechanisms of change. This mixed methods study aimed to explore both longitudinal patient data (neuropsychological and self-report measures, before and after CRT) and therapist experiences of delivering CRT and their perceptions regarding what it offers.
All patients had received treatment in a specialist inpatient unit. Complete data were available for both individual (n=56) and group (n=43) CRT; clinical audit data were also available. Semi-structured interviews of 11 therapists were analysed using Thematic Analysis.
Statistically significant improvements were found in cognitive flexibility task performance for individual CRT (medium effect) and in self-reported cognitive flexibility for group CRT (medium effect). Three main themes were identified from the therapist interviews: “Anorexia and its treatment”, “CRT - its characteristics and delivery” and “CRT and its effectiveness”.
The quantitative findings replicated some previous results and the therapist interviews provided insights regarding not only CRT’s delivery but adaptations made according to individual need and complexity. Both individual and group CRT appear to be feasible interventions for future trials but questions remain around CRT’s specific effects. Recommendations are made for future research studies on this complex intervention.