What is Cognitive Rehabilitation Therapy?
Cognitive rehabilitation therapy (CRT) is a therapeutic approach used to relearn cognitive skills that have changed or been lost following to damage to the brain. If the cognitive skills cannot be re-learned, then the therapist will work with the individual to create compensatory strategies for their lost functions.
Cognitive assessments aim to assess individuals mental processing and will look at the following 5 modules:
- Visual Processing.
- Information Processing.
- Executive Functions.
Each heading can be broken down to include a range of specific cognitive skills required for us to function daily. When an individual has a cognitive impairment, it can have a significant impact on their ability to function, their rehabilitation and their quality of life.
There are four components to CRT:
- Education - This involves educating the individual and/or their family about brain injury, their cognitive strengths and weaknesses. Education aims to increase the individuals' insight and awareness as well as them becoming an expert in their brain injury.
- Process Training - This is the change of cognitive skills via retraining or repeated practice focusing on the impaired cognitive skill.
- Strategy Training - The main focus is on compensatory strategies.
- Functional Activities Training - This is the use of the above three components to real life situations. The overall aim is to make changes to real life scenarios.
What is Cognitive impairment?
Cognitive impairment occurs when the brain has been damaged. It can affect a person's abilities to complete daily tasks in a variety of ways including; making day to day decisions, concentrating on a task or remembering items. Cognitive impairment is common following brain injury and studies have found that cognitive impairment has a greater impact in loss of function than physical impairment. Cognitive impairments can range from mild to severe.
Who is cognitive rehabilitation for?
CRT is aimed at individuals who have had a brain injury and the consequences of the brain injury affect the management of daily living tasks. CRT can improve and/or prevent further loss of cognitive abilities.
The following diagnoses may benefit from CRT, although this is not an exclusive list:
- Hypoxic brain injury
- Brain tumour removal
- Traumatic brain injury
- Brain haemorrhage
The Cognitive Rehabilitation Course:
We would begin by completing an initial assessment, which would predominantly involve gathering information and assessing the individual's cognitive skills. Following assessment, a report will be completed outlining any areas of cognitive impairment and a recommended treatment plan. If it is felt that the individual will be suitable for the cognitive rehabilitation course, then a number of SMART goals will be set between the therapist and the individual.
SMART goals are:
- Specific- the goals set will be specific to the cognitive areas that the therapy sessions are working on.
- Measureable- assessments will be used as outcome measures to evidence any changes.
- Achievable- all goals set will be achievable.
- Realistic- all goals set will be realistic and not outside of the individuals capabilities.
- Timely- all goals will have a timescale to be achieved or reviewed by.
A timetable of sessions will then be drawn up and each session will work towards the SMART goals. As each person is unique, and no two brain injuries are the same, the number of sessions may vary between individuals. Not everyone will require rehabilitation for all 5 cognitive modules outlined above. The assessment and report will outline which cognitive modules are required. Treatment is then carried out 3-5 days a week, approximately 1 hour sessions. On average each module will last for 4 weeks. The time scale can be adjusted to meet the needs of the individual.
The cognitive rehabilitation course is intense, and to see any improvements, it is important that you are 100% committed to the course.
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