Neuropsychology Treatment for Cognitive Deficits

Cognitive remediation is a neuropsychological treatment that can teach long-lasting skills that help restore everyday functioning.  Research has demonstrated that cognitive remediation interventions that incorporated elements of memory, information processing, and attention as well as emotional components led to significant improvements in a number of cognitive areas.

The good news is that everyone, even after treatment for a brain disorder, has intact cognitive abilities and strengths. Cognitive remediation therapy teaches a patient to use those existing abilities to compensate for deficits in other areas. Cognitive remediation in combination with cognitive behavioral therapy incorporates all domains of functioning: emotional, behavioral, and cognitive.

Cognitive rehabilitation is based on the principle of experience-dependent neuroplasticity, meaning that the human brain is not a static organ but can be physically changed. These changes can occur within neural pathways and synapses after exposure to enriched environments. Cognitive remediation provides such an enriched environment.

What is integrated cognitive remediation/cognitive behavioral therapy?

• Cognitive remediation integrated with cognitive behavioral therapy also involves addressing emotional difficulties that go along with awareness in changes in sense of self.  When individuals notice some diminishment in functioning, they can be down on themselves in the form of negative messages to oneself, avoiding things, and withdrawing from life, all of which lead to depression.  Cognitive behavioral therapy in cognitive remediation ensures that these emotional reactions are highlighted and addressed so depression does not set in, understanding of underlying strengths takes place, engagement in meaningful tasks is encouraged and hope is experienced. 
• Cognitive remediation teaches compensatory strategies, such as using a memory notebook or daily planner, as well as using task analysis (the process of breaking down tasks into logically sequenced steps in order to better carry out important activities of daily living.  The central goal is to apply these strategies to everyday life after brain tumor surgery. 
• Cognitive remediation incorporates attention-enhancing exercises that require a variety of neural networks. These attention exercises engage both visual and auditory skills, both of which are essential to many everyday tasks.  Attention and information-processing exercises are designed to enhance information retention and recall, contributing to improvements in memory. 
• Attention, memory, and executive functions are interdependent, and impairments in these areas profoundly impact daily functioning.  Therefore, exercises that increase capacity for attention, working memory, and short-term memory will increase overall mental capacity.  Such exercises also increase an individual’s awareness of the mental effort required to process information. 
• Cognitive remediation is a collaborative treatment in which the individual and provider set goals and then customize treatment in order to reach these goals.

Psychometric testing can help establish the patient’s abilities and strengths and set the stage for remediation. Individuals will also learn how to self-report their cognitive difficulties to help themselves and their treatment provider develop a rehabilitation plan.

Behavioral, emotional, and cognitive changes after brain tumor surgery can be stressful, but with quality rehabilitation a patient can achieve excellent results and a good quality of life.

The Weill Cornell Medicine neuropsychology service within Neurological Surgery is pleased to offer a comprehensive Cognitive Remediation Program that focuses on improving working memory, attention, and focus.  Find out more about the Cognitive Remediation Program.