Feasibility and Preliminary Outcomes of Web-Based Cognitive Remediation Therapy in Psychiatric Inpatients With Psychotic Disorders: A Pilot Pre–Post Study Using the MATRICS Consensus Cognitive Battery

Background : Cognitive impairments are a core feature of psychotic disorders and are strongly associated with long-term functional disability. Cognitive Remediation Therapy (CRT) is an evidence-based intervention for improving cognition in psychosis; however, its feasibility and preliminary cognitive effects in acute inpatient settings—particularly using web-based platforms—remain underexplored. This pilot study evaluated the feasibility of delivering a web-based CRT program in an inpatient psychiatric setting and examined preliminary cognitive outcomes. Methods : This single-arm, pre–post pilot study was conducted in a secure psychiatric inpatient facility. Thirteen inpatients with psychotic disorders participated in a 15-week web-based CRT program delivered twice weekly (30 sessions total). Each session comprised approximately 50 minutes of adaptive computerized CRT exercises (Happy Neuron Pro) followed by a 40-minute therapist-led bridging discussion focused on metacognitive reflection and application of cognitive strategies to daily activities. Cognitive performance was assessed before and after the intervention using the MATRICS Consensus Cognitive Battery (MCCB). Feasibility outcomes included session attendance, study retention, and completion of pre–post cognitive assessments. Results : All participants completed pre- and post-intervention cognitive assessments, with no study withdrawals or adverse events reported. Participants attended a mean of 27.77 (SD = 5.28) of 30 scheduled sessions, corresponding to a mean attendance rate of 93.0%. Pre–post improvements were observed in processing speed, verbal learning, and overall composite cognition, with large within-sample effect sizes. Sensitivity analyses excluding outliers confirmed robustness of these findings. Exploratory regression analyses suggested potential associations between sex and history of self-harm with cognitive change; however, these findings should be interpreted cautiously given the small sample size. Conclusions : The findings support the feasibility of delivering web-based CRT with structured bridging discussions in an inpatient psychiatric setting and suggest a preliminary signal of cognitive benefit. Given the pilot, single-arm design, results should be considered hypothesis-generating. Further research using controlled designs and larger samples is warranted.