Cognitive Remediation in Mental Health
Cognitive deficits are common in psychiatric disorders and often represent key components of these conditions. Rehabilitative techniques that focus on improving cognitive functions are generally referred to as cognitive remediation. This chapter focuses o
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Cognitive Remediation in Mental Health Benjamin D. Hill, Channing Sofko and Anneliese C. Boettcher
Introduction Cognitive deficits are common in psychiatric conditions and they are often core features of the disorders. Cognitive impairments in severe psychiatric disorders can be quite dramatic and can significantly interfere with quality of life and treatment outcomes. As such, techniques for improving cognitive functioning in psychiatric populations are garnering attention and becoming a focus of intervention research. These techniques are typically categorized as cognitive rehabilitation or cognitive remediation. We will generally use the term cognitive remediation throughout this chapter. However, some experts contend that cognitive rehabilitation refers to interventions that are general in nature and cognitive remediation is more concerned with techniques developed for specific etiologies. The distinction between these two intervention categories will be discussed in more detail, but we will use the term cognitive remediation to categorize a range of behavioral interventions using targeted training exercises designed to improve cognitive functioning (Eack 2012). Cognitive remediation was designated a “best practice” treatment for severe mental disorders
B.D. Hill (&) C. Sofko Anneliese C.Boettcher Department of Psychology, UCOMM 1500, University of South Alabama, Mobile, AL 36688, USA e-mail: [email protected]
by the APA/CAAP Task Force on serious mental illness and severe emotional disturbance (2007) and these interventions typically focus on improving cognitive processes, such as attention, memory, and higher level executive functions, including social cognition. The goal is to train and strengthen specific cognitive processes that will then generalize and result in long-term improvement (Medalia 2010). Remediation interventions are often used in conjunction with compensation approaches that attempt to circumvent deficits, but these are conceptually distinct rehabilitation techniques (Pella et al. 2008).
Neuroplasticity The field of cognitive remediation capitalizes on neuroplasticity (Bruel-Jungerman et al. 2007). Neuroplasticity is the neurobiological process by which learning and environmental factors alter cognitive processing. An example of neuroplasticity is when individuals who lose motor skills following brain injury are able to improve motor functioning through practiced approximations of the lost skills resulting in neurobiological changes in the affected cortex (Robertson and Murre 1999). Many of the guiding principles of cognitive remediation that are currently used in practice were initially developed in the realm of brain injury rehabilitation. (e.g., Ben-Yishay et al. 1985; Hogarty and Flesher 1999). The guiding principle in brain injury rehabilitation is to
© Springer International Publishing Switzerland 2016 N.N. Singh et al. (eds.), Handbook of Recovery in Inpatient Psychiatry, Evidence-Based Practices in Behavioral Health, DOI 10.1007/978-3-319-40537-7_8
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