Cognitive dysfunction is considered to be one of the causes of disability in schizophrenia. The aim of cognitive rehabilitation or cognitive remediation is to improve cognitive functioning and/or acquire compensatory skills. The effects of cognitive rehabilitation have been proved in randomized clinical trials, and they have also been reported in Japan. The original program in Japan was developed recently. The intervention methods are enhancing cognitive skills of schizophrenia patients and the transfer of learned skills into the real world. Strategies of learning, however, differ from bottom-up to top-down, from repetitive drills, acquiring strategies of practicing cognitive tasks, to learning compensating skills of cognitive dysfunction. The merits of using computer games which simulate the real world are found in cognitive rehabilitation. The improved competitive employment rate of those with severe mental illness has been reported with a combination of supported employment and cognitive rehabilitation. This result has been replicated in Japan. Cognitive rehabilitation must be used in the context of psychiatric rehabilitation focusing on hope and life goals of persons with schizophrenia. The principle and technologies of developing a learner's intrinsic motivations and initiatives are important. The improved cognitive skills resulting from cognitive rehabilitation would be further improved if transferred into a learner's real life in a timely fashion.
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