In May we launched our cognitive remediation program in our Intensive Psychiatric Rehabilitation Treatment (IPRT) program. Cognitive remediation is an evidenced-based practice to improve basic cognitive skills such as memory and concentration using computer software and web based programs. The cognitive deficits our program targets are problem solving, processing speed, reasoning and logic, concentration, planning, attention, working memory, organization, and working memory, as well as, short and long term memory.
Ten members of our staff became certified as Cognitive Remediation Specialists and were trained in the Neuropsychological Educational Approach to Remediation (NEAR) model. They consulted and worked together on this program with
Dr. Alice Medalia, Professor of Clinical Psychiatry (in Psychology) and Director of Psychiatric Rehabilitation at Columbia College of Physicians and Surgeons. Dr. Medalia is an international leader in the field of cognitive remediation and an advocate of recovery-based interventions that address cognitive dysfunction in people with psychological disorders. She has written Cognitive Remediation for Psychological Disorders, along with Dr. Nadine Revheim, Research Psychologist in the Program of Cognitive Neuroscience and Schizophrenia at the Nathan Kline Institute for Psychiatric Research in Orangeburg, NY and Tiffany Herlands, PsyD, Assistant Professor of Psychiatry and Director of Rehabilitation Psychology at Columbia Presbyterian Eastside.
Groups meet twice a week in our Vocational Resource Center over a period of ten weeks. In the beginning of group participants discuss with staff what they previously worked on in the last session and decide what they want to accomplish for the current session. Group members then work individually on a computer with software and web based programs to practice their skill. The last fifteen minutes of the session are dedicated to “bridging”, which is done in a group setting. This refers to the process of generalizing cognitive skills and compensatory strategies learned on the computer to everyday life. To evaluate an individual’s progress within the program, pre and post assessments are given to each participant to measure their cognitive functioning.
Below are some screen shots from the computer programs that participants use to develop specific skills. An individual’s level of computer literacy is not a barrier to program participation, as all cognitive remediation programs are user friendly and only require the participant to ‘point and click.’
This exercise is called Stocktopus. The goal of this exercise is to trade items in order to attain goal items. This exercise targets problem solving, attention, concentration, and working memory.
This exercise is called Fripple Place. The user must use clues on the screen as well as those provided by fripples in order to place the fripples into the correct craters. This exercise targets working memory, logic and reasoning, problem solving, attention and concentration.
Cognitive remediation is on the forefront of rehabilitation; it is a program that helps participants with mental illness to improve their level of functioning in everyday life whether it be in school, work, social interactions or independent living. Kevin B., one of the participants states, “The group is fun. I feel much better about myself now.”
We’d like to thank the Fay J. Lindner Foundation for funding this program.
Carol Love was first referred to The Bridge through the New York state Adult Career and Continuing Education Services-Vocational Rehabilitation (ACCES-VR) program. She stayed on as an IPRT client and was working toward a goal of going to school for medical billing and coding. Carol has been living independently for 8 years now, and prides herself on her organizational skills and work ethic.
