Cognitive Remediation Therapy for Kids & Adults in Columbus, Ohio
Live in or around the Columbus Ohio area and interested in cognitive remediation therapy (CRT)?
Over the next couple minutes I’d be honored to chat with you about CRT and how I incorporate it into my practice to improve the lives of my patients by correcting cognitive impairments.
Note: When we speak about cognition, we’re referring to the mental actions or processes of acquiring knowledge and understanding through thought, experience, and the senses. It’s an incredibly dynamic subject, but in summary it’s how we think and process our thinking.
Most adults have a favorite teacher from their youth. I know I do. You probably have a teacher from yesteryear you still admire. When pestered why these particular sages became our favorites, it’s because they empowered us somehow to more effectively harness our minds.
The same is true across the world – those that leave the biggest impressions on our lives are those that help/show us how to think with more clarity and improve our mental faculties.
As they say, knowledge isn’t power. The yardstick of power is measured in what one does with knowledge. For everyday healthy folks, online or app-based brain training programs are a popular option, whereas CRT is directed towards brain-related or neuro-cognitive impairments/deficits.
As such CRT has a variety of applications.
Core examples include, but aren’t limited to:
• Traumatic Brain Injury (TBI); post stroke conditions; Attention Deficit Hyperactivity Disorder (ADHD).
• Youth with higher-functioning autism spectrum disorders and serious learning disabilities.
• Bipolar; Depression; PTSD patients with cognitive disabilities; Schizophrenia; Alzheimer disease, early stage dementia.
Where I differ as a clinician is I’m not administering brain training games. I’m a licensed and practicing psychiatrist here in Columbus, Ohio, with a long history treating individuals and helping families dealing with these issues.
My approach combines elements of restorative 1-on-1 psychotherapy with CRT, which is both 1-on-1 and delivered as a set of structured exercises children and adults can get done at home via computer.
The exercises are directed at or targeting specific cognitive functions including:
• Processing speed.
• Working, prospective and long term memory.
• General & selective attention.
8 Visual perception.
The goal is always the same: to earn holistic improvements through work that produces positive impacts – career, education, relationships, emotionally and psychologically.
Signs CRT May Improve Your Life
Aside from TBI or being medically diagnosed with ADHD or other issues listed above, one could show a wide variety of signs. And, it’s very situational; contextual. There are extremely functional and ‘successful’ people who likely display lower levels of clinical ADHD, depression, Bipolar, etc., symptoms or behaviors.
Here are three more potential signs.
• It’s difficult to pay attention for a either a long or short period or time. Again, I know writers, designers and creatives that are like this for a living! But if it’s a problem…
• Easily distracted by sounds in your environment. Often, people will attempt to drown out all ambient sound with loud music, or TV or podcasts.
• Frequently have to ask for instructions to be repeated over and over, and over. It’s extremely hard to take in even simple explanations right after they’re presented.
Picture the 5th grader, a 10-year-old girl, who spends hours every single day on homework only to have trouble recalling content come test time. Or, a middle-aged man dealing with TBI, or the 60-something recovering from a stroke.
We all have brains. When there’s an issue impacting cognition, CRT and similar methodologies have a proven track record of results. I believe in a multifaceted approach.
What About Medications?
With medications it’s a case-by-case reality. Sometimes people taking part in CRT may be using medications because of surgery, or something related to a brain injury, or severe depression, etc.
But, are there ‘drugs’ I as a psychiatrist can prescribe to improve your brain function?
For a more general perspective concerning strategies for cognitive remediation based on research other than my own, we can turn to Dr. Lauren Krupp, Professor of Neurology at NYU Langone School of Medicine and Director of the Multiple Sclerosis Division.
After a speech, she was interviewed by a Dr. Kantor and asked whether any medications have shown promise towards improving cognition. Her response was,
“The bottom line is…pills that are supposed to help you think better, they don’t work, basically they’re just not that effective. What that means is some of the other strategies that turn out to be incredibly effective, are specific forms of cognitive remediation…”
• 1-on-1 training and working with a cognitive rehab therapist or psychiatrist.
• Computer-based methods of cognitive remediation that can be done at home.
• Exercise, specifically aerobic exercise, has very positive effects on cognitive abilities like thinking speed and memory.
Strategies & Repetition
Whether through injury or genetics, when the brain’s cognitive abilities are frazzled, or like a puzzle that isn’t put together quite right, it’s about using specific remediation therapies and repetition – week after week, for typically a minimum of 12 weeks.
No different than carving the many pathways it takes to learn, or re-learn, how to play a new classical piece on the piano.
Picture the stout ship captain who’s been injured, had a good portion of his brainstem destroyed in an accident and who must now relearn to see, walk, cook, etc. With CRT we’re focused on memory, emotional stability, and the healthy processing of information, not teaching folks how to regain control of their legs.
Strategies and repetition, with proven results, which will oftentimes not include any medication, or at least any additional medications.
CRT Example for Teens & Adults
To start reeling in the idea, take a minute to check out short videos like, “Improving Working Memory Exercise at Equipping Minds.” That particular video is a little over 2 minutes, but gives you foundational levels of what it’s like to go through a very short stack of cards.
What that exercise is doing is forcing you to tap into working memory, switching cognition from numbers, to colors, to shapes, while testing processing speed. Depending on your intelligence and situation, you can increase complexity as needed.
Now, can you see cognitive improvements watching videos like that on your own regularly and putting in the work week after week? Sure, but some people see much better results when guided by a trained CRT professional and/or psychiatrist.
CRT Computer-Based Example for Kids
The child sits down in front of the computer or with their laptop or tablet and begins a session. They’re shown animations or graphics explaining they’ll hear a series of names, the names of all kinds of different things.
Whenever they hear the name of something that’s in the kitchen, they’re instructed to click a button or checkbox. At the same time they could be shown images of other things, or not. There are endless ways to challenge and improve cognition, whether you’re 6, 16, 46, 66…
A Sampling of Research
CRT isn’t designed to replace medication, medical treatments or psychotherapy, but compliment their impacts.
Each type of treatment plays a role in recovery and getting back to ‘normal’ so to speak:
• Medication to impact on the neurological level.
• Psychotherapy to impact on the psychological level.
• CRT to impact on the processing of information.
For research, there’s isn’t a vast amount but what exists goes back a ways and is very clear.
To save time let’s choose one condition relative to CRT, and look at a little of the available research. For example, ADHD. We can begin with this 2006 study of Cognitive Remediation published through the Dept. of Psychology and Trinity College Institute of Neuroscience, Dublin where they found,
“Our data demonstrates that sustained attention performance can be enhanced in children with ADHD using a simple cognitive training strategy. Methods from the field of cognitive rehabilitation may be viably applied to the remediation of attention deficits in ADHD.”
Again, my approach is to combine these cognitive strategies with psychotherapy. We could go back even further to 2002, to the Australian & New Zealand Journal of Psychiatry where they looked at the efficacy of a Cognitive Remediation Program for Adults.
Their clinical trial results showed,
“Participants who completed the CRP reported reduced ADHD symptomatology, improved organizational skills and reduced levels of anger. Clinically significant improvements in ADHD symptomatology and organizational skills were maintained one year after the intervention. These findings suggest that the CRP provides a practical way of enhancing daily functioning for adults with ADHD.”
So it shouldn’t surprise you to find out that when looking at the rapid rise of this treatment, and the widespread acceptance, more and more programs, schools, and therapy-based startups are appearing.
C8 Sciences is one such alternative school, who in 2014 published an article entitled, Why Computerized Cognitive Training Programs are the Future of ADHD Therapy.
“Computer-assisted remediation applications have been utilized for people with learning disabilities and ADHD with great success, and it is believed by many neuroscience professionals that this is the future of ADHD therapy. The interventions have shown, in most cases, to:”
• Increase working memory.
• Sustain attention.
• Help children (and adults) focus attention to discriminate and selectively attend to stimuli.
• Increase self-regulatory error detection and correction.
• Decrease impulsivity.
Interested? Need Help?
If you’re in or around the Columbus Ohio area and interested in cognitive remediation therapy, or have questions, please use the information on my Contact Page to get a conversation started. Or, feel free to post questions in the comments section. Cheers! Thanks for your time. I hope this article is helpful.
