Effectiveness of Cognitive Remediation and Emotion Skills Training (CREST) for Anorexia Nervosa in Group Format: A Naturalistic Pilot Study

Abstract

This study aims to evaluate a novel and brief skills-based therapy for inpatients with anorexia nervosa, which addressed 'cold' and 'hot' cognitions in group format. Adult inpatients with anorexia nervosa participated in the cognitive remediation and emotion skills training groups. Participants who attended all group sessions completed patient satisfaction and self-report questionnaires. Analysis of the data showed that social anhedonia (measured by the Revised Social Anhedonia Scale) decreased significantly between pre- and post-interventions, with small effect size (d=0.39). Motivation (perceived 'importance to change' and 'ability to change') was found to have increased with small effect sizes (d=0.23 and d=0.16), but these changes did not reach statistical significance. The cognitive remediation and emotion skills training group had positive feedback from both the patients and therapists delivering this structured intervention. Improved strategies are needed both in supporting inpatients to tolerate the group therapy setting and in helping them to develop the skills necessary for participation. Further larger-scale research in this area is needed to consolidate these findings.