Cognitive Behavioral Therapy vs. Cognitive Remediation Therapy: What's the Difference?

What's the Difference: Cognitive Behavioral Therapy vs. Cognitive Remediation Therapy

When a rose is not quite a rose…

I often use the phrase, “A rose by any other name smells just as sweet,” especially when discussing the many labels we assign to treatment approaches, therapeutic models, and clinical tools. But during a recent supervision session, I was asked a thought-provoking question:

"Are Cognitive Behavioral Therapy (CBT) and Cognitive Remediation Therapy (CRT) the same thing? Is CRT just a newer name for CBT?"

The short answer is: No, they are not the same. On the surface, they may seem alike, but while both approaches involve working with cognitive processes, they differ significantly in their goals, techniques, and areas of application. Below is a brief explanation of each to clarify the distinctions.

Cognitive Remediation Therapy (CRT)

➤ Focus

CRT is designed to improve cognitive functions such as memory, attention, processing speed, problem-solving, and executive functioning. It is often used with individuals experiencing cognitive impairments due to conditions such as schizophrenia, ADHD, depression, brain injury, or dementia.

➤ Goal

The central aim is to enhance cognitive skills so that individuals can function more effectively in daily life – whether in work, learning, or social contexts.

➤ Techniques

The central aim is to enhance cognitive skills so that individuals can function more effectively in daily life – whether in work, learning, or social contexts.

➤ Approach

CRT is not primarily about thoughts or emotions. Rather, it’s a form of cognitive rehabilitation or training – more aligned with neuropsychology than with traditional psychotherapy. It's about skill-building, not thought-changing.

According to the Association for Behavioral and Cognitive Therapies (ABCT):

"Cognitive Remediation ... is a behavioral intervention targeting problems with cognition ... with the ultimate goal of improving day-to-day community functioning."

Cognitive Behavioral Therapy (CBT)

➤ Focus

CBT focuses on the relationship between thoughts, emotions, and behaviors. It is used to treat a wide range of mental health conditions including anxiety, depression, PTSD, OCD, and many others.

➤ Goal

The primary goal is to identify and change negative or unhelpful thinking patterns and behaviors that contribute to emotional distress. The emphasis is on developing healthier, more adaptive ways of thinking and behaving.

➤ Techniques

CBT includes methods such as cognitive restructuring, thought challenging, behavioral experiments, and exposure strategies. It is a collaborative and goal-oriented process.

➤ Approach

CBT is a psychotherapeutic approach rooted in emotional regulation. It addresses how beliefs and thoughts influence emotions and behaviors, helping individuals learn to respond to challenges in more constructive ways.

Key Differences at a Glance

As Aaron T. Beck, a pioneer of CBT, noted:

"Cognitive therapy... stress[es] the importance of internal events such as (dysfunctional) thoughts, belief systems, conditional, and unconditional"

In Summary

CRT is about training the brain – helping individuals regain or strengthen cognitive abilities that may have been impaired.

CBT is about changing the mind – teaching individuals to recognize and reshape unhelpful thought patterns to improve emotional wellbeing.

So, while I still enjoy using metaphors like “a rose by any other name”, this is one of those times when the metaphor does not quite hold. CRT and CBT may both deal with cognition, but they serve very different purposes and should not be used interchangeably.

In short: not all roses are the same – some are for planting, others for pruning, and still others for gifting or for display. And in the therapeutic world, knowing the difference matters.