Cognitive Rehabilitation Therapy – The Two Pronged Way

Two Pronged Brain

Here at last! I thought I was never going to get this uploaded. And still in November too.

Let’s turn our attention back to Cognitive Rehabilitation Therapy (C.R.T.)

Why?

  1. We haven’t talked about C.R.T. for a long time.
  2. Someone recently asked what they could do at home to help their loved-one themselves. (I’ve found a Youtube post that should help. See below.)

(Definition)

There are many. It seems every organisation the world over has its own description of what CRT is. Here’s my “in a nutshell” definition:-

Cognitive Rehabilitation Therapy is a collaborative series of tasks and discussions between therapist(s) and patient(s) / client(s) aimed at helping those patient(s) / client(s) cope with themselves and the wider world after a brain injury.

The implication for Cognitive Rehabilitation Therapists, be they grounded in classical Cognitive therapies or Person-centred therapies, is that C.R.T. involves both active listening and active thinking.

What do I mean by “active thinking”? I mean empathically thinking as the client thinks.

Art of cinversation

(Comprehensive)

Cognitive Rehab’ Therapy takes a two pronged approach. The Person-centred or “Multi-modal” (“Comprehensive”) prong takes account of emotions, behaviour and perceptions altogether.  Active listening flags up the patient’s / client’s motivation or lack of it – gauges what stimulates by whatever degree and how. A therapist can then intuit techniques and interventions to best aid the patient’s / client’s understanding and skills.

The relationship is one of observation – reflection or open question – reaction – observation – response. Such in-the-moment to-ing and fro’-ing between therapist and patient / client can result in unforeseen recognitions. I’m talking about immeasurable and surprising reconnections and new connections within the “neuro-person”, if I may call them that.

(Modular)

The Modular prong is more targeted. Its focus is on areas of damaged brain, not always the holistic person. Formulated exercises are aimed at improving attention, memory, visual and information processing, language or executive functions.

Single modules can be used for an isolated or overriding impairment. Selected modules can be used in group settings or tailored to individual patients / clients. Though less precise in delivery, modular, task orientated group therapy helps in the following ways:-

  • By facilitating peer support.
  • Problem solving by discussion gives greater chance to strengthen confidence, co-operation, as well as some empathy.
  • Less rigid, more flexible problem solving skills – “thinking sideways” also has greater chances to develop.

(Family Involvement)

How about that Youtube link? Clinical neuropsychologist, Tedd Judd, PhD. offers family members advice on how to approach helping a brain injured loved-one. (8.5 minutes.) Click here to watch. (Skip the advert.)

There is every reason to include family members in therapy when and where appropriate and possible.

When couple counselling I find it helps the couple best if we view their relationship as the client. Thinking sideways, it’s not difficult to shift this way of working to a wider family context. After all, it’s the relationship with and around a loved one with the acquired brain injury that needs to readjustment as much as A.B.I. survivor themselves.

More next month. Take care for now.

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