Cognitive Remediation Therapy (CRT) is a novel intervention developed for adults with anorexia nervosa (AN), which aims to improve “cognitive flexibility” and “holistic processing” thinking styles (Tchanturia et al., 2008; Tchanturia & Hambrook, 2009). The present study uses a qualitative approach to examine therapists’ accounts of their work with inpatients suffering with AN. The objective of this study is to gain a broader understanding of how CRT has been implemented and utilized in daily life by this patient group. Therapists’ letters were positive and motivational; acknowledging patients for their achievements while outlining some of the difficulties and emotions that patients experienced. Findings highlight that the majority of patients’ difficulties related to their metacognitive ability and in transferring the skills to real life. Themes also concerned the processes and stages of CRT, where patients gradually drew skills from the intervention prior to making changes in their own lives. The implications of this approach for working with adolescents with eating disorders are explored. It is hoped that this study will help understanding of how CRT can be used as a treatment for AN; and how it could be developed for future work with young people.
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR (Text Revision) . Washington DC: APA Press.
2.
Baldock, E., & Tchanturia, K. (2007). Translating laboratory research into clinical practice: Foundations, functions and future of cognitive remediation therapy for anorexia nervosa. Therapy, 4(3), 285-293.
3.
Genders, R., Davies, H., St Louis, L., Kyriacou, O., Hambrook, D., & Tchanturia, K. (2008). Long-term benefits of CRT for anorexia. British Journal of Healthcare Management, 14(12): 15-19.
4.
Genders, R., & Tchanturia, K. (2010). Cognitive Remediation Therapy (CRT) for anorexia in group format: A pilot study. Weight and Eating Disorders, 15, 234-239.
5.
Gilberg, I., Rastam, M., Wentz, E., & Gilberg, C. ( 2007). Cognitive and executive functions in anorexia nervosa ten years after onset of eating disorder. Journal of Clinical and Experimental Neuropsychology, 29, 170-178.
6.
Glaser, B.G., & Strauss, A.L. ( 1967). The discovery of grounded theory: strategies for qualitative research. New York: Aldine.
7.
Happe, F., & Frith, U. ( 2006). The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36, 5-25.
8.
Lock, J.D., & Fitzpatrick, K.K. (2009). Anorexia nervosa. British Medical Journal Clinical Evidence, 1(1011), 1-19.
9.
Lopez, C., Stahl, D., & Tchanturia, K. (2010). Estimated IQ in anorexia: A systematic review of the literature. Annals of General Psychiatry, 9, 40.
10.
Lopez, C., Tchanturia, K., Stahl, D., Booth, R., Holliday, J., & Treasure, J. ( 2007). An examination of the concept of central coherence in women with anorexia nervosa. International Journal of Eating Disorders, 41(4), 340-347.
11.
Lopez, C., Tchanturia, K., Stahl, D., & Treasure, J. ( 2008). Central coherence in eating disorders: a systematic review . Psychological Medicine, 38(10), 1393-1404.
12.
National Institute for Clinical Excellence (NICE). ( 2004). Core interventions for the treatment and management of anorexia nervosa, bulimia nervosa and related eating disorders. NICE Clinical Guideline no.9 (http://www.nice.org.uk ).
13.
Nunn, K.P., Frampton, I., Gordon, I., & Lask, B. ( 2008). The fault is not in her parents but in her insula - a neurobiological hypothesis of anorexia nervosa. European Eating Disorders Review, 16(5), 355-360.
14.
Park, H.S., Shin, Y.W., Ha, T.H., et al. (2006). Effects of cognitive training focusing on organizational strategies in patients with obsessive-compulsion disorder . Psychiatry and Clinical Neurosciences, 60, 718-726.
15.
Pretorius, N., & Tchanturia, K. (2007). Anorexia nervosa how people think and how we address it in psychological treatment. Therapy , 4(4), 423-433.
Roberts, M.E., Tchanturia, K., Stahl, D., Southgate, L., & Treasure, J. ( 2007). A systematic review and meta-analysis of set shifting ability in eating disorders. Psychological Medicine, 37(8), 1-12.
18.
Schmidt, U., & Treasure, J. ( 2006). Anorexia nervosa: Valued and visible. A cognitive-interpersonal maintenance model and its implications for research and practice. British Journal of Clinical Psychology, 45(3), 1-25.
19.
Tchanturia, K., Brecelj, M., Sanchez, P., Morris, R., Rabe-Hesketh, S., & Treasure, J. ( 2004). An examination of cognitive flexibility in eating disorders . Journal of International Neuropsychology, 10, 513-520.
20.
Tchanturia, K., Campbell, I., Morris, R., & Treasure, J. ( 2005). Neuropsychological studies in AN. International Journal of Eating Disorders, 37, 572-576.
21.
Tchanturia, K., Davies, H., & Campbell, I. ( 2007). Cognitive remediation for patients with anorexia nervosa: Preliminary findings. Annals of General Psychiatry, 14, 1-6.
22.
Tchanturia, K., Davies, H., Lopez, C., Schmidt, U., Treasure, J., & Wykes, T. ( 2008). Neuropsychological task performance before and after cognitive remediation in anorexia nervosa: A pilot case series. Psychological Medicine, 38(9): 1371-1373.
23.
Tchanturia, K., & Hambrook, D. ( 2009). Cognitive remediation for anorexia nervosa. In C. Grilo & J. Mitchell (Eds.), The treatment of eating disorders: Clinical handbook (pp. 130-150). New York: Guilford Press.
24.
Tchanturia, K., & Lock J. ( 2011). Cognitive remediation therapy (CRT) for eating disorders: Development, refinement and future directions. Current Topics in Behavioral Neuroscience, 6: 269-287.
25.
Tchanturia, K., Morris, R., Brecelj, M., Nikolau, V., & Treasure, J. ( 2004). Set shifting in anorexia nervosa: An examination before and after weight gain, in full recovery and the relationship to childhood and adult OCDP traits. Journal of Psychiatric Research, 38, 545-552.
26.
Tokley, M., & Kemps, E. ( 2007). Preoccupation with detail contributes to poor abstraction in women with anorexia nervosa. Journal of Clinical and Experimental Neuropsychology, 29(7), 734-741.
27.
Whitney, J., Easter, A., & Tchanturia, K. (2008). Service users’ feedback on cognitive training in the treatment of anorexia nervosa. International Journal of Eating Disorders, 41(6), 542-550.
28.
Wilson, B. ( 2004). Theoretical approaches to cognitive rehabilitation. In L. H. Goldstein, & J. E. McNeil (Eds), Clinical neuropsychology: A practical guide to assessment and management for clinicians (pp. 345-367). Chichester: John Wiley & Sons Ltd.
