CREST – Cognitive Remediation and Emotional Skills Training for Eating Disorders

Individuals with Anorexia Nervosa can experience difficulties with emotions, particularly with identifying and labelling emotions both in themselves and others.  Therefore, this can lead to a lack of awareness with one’s own emotional needs.  Furthermore, those with Anorexia Nervosa can experience extremes of the emotional spectrum.  For example, they could either experience an emotion which is out of proportion to the trigger or they may be unable to experience an expected emotion at all.  As a result of this, individuals with Anorexia Nervosa can experience difficulty in the processing and managing of these intense emotions.  For example, some individuals starve themselves as a method of lessening their emotions or alternatively as a maladaptive way of expressing their emotions. Inability to express emotions and self-censorship of emotional expression can become problematic when an individual isolates themselves from other people or when they ignore what the emotion is trying to tell them about their needs.  Therefore, CREST was created as a therapy to highlight the importance of recognising and expressing emotions.

Cognitive Remediation and Emotional Skills Training’ also known as ‘CREST’ is a type of therapy which can be used as part of a treatment for eating disorders, particularly Anorexia Nervosa. CREST addresses the importance of understanding and identifying emotions whilst providing a safe space to learn techniques and skills to help recognise and regulate emotions. CREST can be used as a psychological intervention immediately after admission to an inpatient unit and can be given alongside other therapies.

CREST sessions involve simple thinking exercises, discussion of scenarios and games which encourage the Service User to identify and develop personal strategies to manage their emotions. Additionally, this therapy challenges misconceptions about emotions by highlighting the feeling and sharing the negative and positive emotions so that this does not reflect badly on the individual. Overall, CREST is a useful therapy which should be used alongside other interventions to treat Anorexia Nervosa and can often be used as a starting point for more in-depth individual therapy.

Rhodes Wood Hospital provides specialist inpatient care and treatment for children and young people aged 8 -18 years old with an eating disorder.

Our expert multi-disciplinary team provide person-centred care that is tailored to meet the physical and medical/mental health needs of each individual, to support them through their journey with us and to continue their treatment in the community.



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