What is cognition?

All of the mental activities that are involved in learning, remembering, and using knowledge.

Mental processes involved include attention, judging, knowing, learning, perceiving, recognizing, remembering, thinking, and understanding using both verbal and nonverbal abilities.

Cognitive impairments that can occur in psychosis:

Individuals with psychosis may experience some or all of these cognitive problems:

  • Decreased attention
  • Decreased speed of processing Information
  • Decreased memory
  • Decreased reasoning and thinking abstractly
  • Decreased learning
  • Decreased ability to understand social information like body language, emotional expressions or jokes

Cognition and function in everyday life:

Any of the cognitive deficits above may impair learning, daily functioning and interfere with meaningful occupations/roles.

Research indicates cognitive abilities are the best predictor of a person’s ability to function in the world (e.g. at work or school or in social situations). Psychotic symptoms such as hallucinations, delusions, etc. are not as good as cognitive functioning in predicting whether a person is function in life roles or successfully return to life roles (e.g. someone who is still experiencing hallucinations or delusions may still be able to keep working if their cognitive skills are intact)

Example of how cognitive impairments can impact your function at school and work:

  • Decreased ability to concentrate and stay on-task – e.g. finding it hard to focus and understand when reading
  • Difficulty remembering what needs to be done – e.g. having a hard time remembering what your teacher or boss asked you to do
  • Difficulty organizing what needs to be done – e.g. doing school or work assignments on time
  • Taking longer to learn new information – e.g. needing a lot of reminders to get something done
  • “Zone out” or work at a slower pace – e.g. looking distracted and disconnected to others
  • Difficulties with change and/or problem-solving – e.g. figuring-out what do to next when you finish a task at work
  • Difficulty sticking with school or work – e.g. quitting your job or dropping-out of school because you’re having trouble following along
  • Difficulty interacting with others – e.g. finding it ‘too much’ to be around people

What can be done about cognitive deficits? …Cognitive Rehabilitation!

Cognitive rehabilitation begins with cognitive assessment by a qualified professional such as a psychologist. The assessment will clarify what aspects of cognition are impaired and guide appropriate interventions

Cognitive rehabilitation can involve compensatory and/or remediation strategies:

Compensation Strategies:

  • Bypass or compensate for cognitive deficits by teaching strategies to manage difficulties associated with cognitive impairments.
  • For example:
    • Learning to use Internal Memory Techniques such as chunking information when learning a new phone number, or putting grocery items into mental categories when trying to remember a grocery list
    • Using External Memory Aids such as calendars, alarms, post-it notes, etc.

The Dealing With Psychosis Toolkit has an entire chapter devoted to helping people learn ways to deal with some of the cognitive issues that may be present.


  • A type of rehabilitation treatment offering exercises to improve attention, memory, language, processing speed, etc.
  • It is expected that improved cognition will result in better functioning in everyday life
  • Proper treatment can enhance social and work/school life
  • Not meant to replace medical treatments or certain types of psychotherapy but rather to complement their effects
  • Cognitive remediation efforts are best used with individuals who are clinically stable and are actively involved in their own treatment
  • Most successful when paired with 1:1 coaching and integrated with functional goals, such as work, school, or recreation