Updated: Aug 29
What Is Cognitive Rehabilitation?
Cognitive rehabilitation therapy (CRT) and cognitive training are thoroughly studied genres of mental and brain therapies that aim to restore the brain’s primary functions after being impacted by mental or physical illness. Those primary cognitive functions can be divided into a number of categories such as:
Attention and concentration
Learning and memory
CRT is most commonly used for patients who have experienced a traumatic brain injury (TBI), stroke, ADHD, multiple sclerosis, dementia, and Alzheimer’s. It has also been shown to positively impact people with depression.
CRT isn’t a one size fits all kind of rehabilitation! There are many different kinds of CRT that can benefit the patient on their journey toward healing the brain. The primary goal of CRT is to improve people’s ability to effectively take in and process information. This can help them get back on track so that they resume their day-to-day lives and feel better about their capacity to think optimally.
Neuroplasticity is the wonderful built-in capacity of our brain to adapt and change depending on what input we receive from our environment. Doctors often use cognitive exercises that aim to strengthen and sharpen cognitive function and increase neuroplasticity through hands-on exercises and activities.
Common Types Of Cognitive Rehabilitation Therapy
Different types of CRT work most effectively for different conditions. CRT is a blanket term to describe several different rehabilitative mental strategies, and clinical providers often use different methods to work directly with their patients. For example, someone with attentional problems might get treatment specifically with attention and concentration, while a patient with early dementia symptoms might focus on building learning and memory skills.
Restorative Cognitive Rehabilitation Therapy
The main goal of restorative cognitive rehabilitation therapy is to bring the mind back to mental acuity and heal the brain fully so that it can function as it did before the concussion or brain trauma. In order to help a patient do this, the healthcare provider might use games, memory worksheets, or digital activities to challenge the patient's deficits and retrain their brain flow. Harnessing individual strengths is always beneficial when targeting areas of cognitive challenge.
Restorative cognitive rehabilitation therapy often focuses on improving gaps in the patient’s concentration, memory, ability to be attentive, learning abilities, sequencing skills, planning skills, the accuracy of perceptions, and the ability to make sound judgments.
Compensatory Cognitive Rehabilitation Therapy
Compensatory CRT is the opposite of restorative CRT, in which the goal of the therapy isn’t to heal the brain fully but to provide the patient with the tools they need to live successfully with long-term brain trauma. In our clinic, we offer our patients worksheets with compensatory strategies.
Compensatory therapy often helps patients learn to use external tools like daily alarms, assistive speech devices, memory tools, or planners to keep them from letting their injury set them back in daily life.
Bottom-Up Cognitive Rehabilitation Therapy
Categorized separately from restorative and compensatory CRT are two main methods clinical providers use to aid brain trauma: top-down or bottom-up CRT. Each of these approaches primarily tries to restore different sets of skills in the recovering patient so that an additional set of cognitive skills grows as a secondary consequence.
The bottom-up approach to rehabilitation focuses on restoring cognitive abilities as they relate to skills like attention to detail, sensory processing, and the accuracy of perceptions. The belief with this approach is that, after these skills are nurtured repetitively, higher-level processes will grow stronger in the aftermath.
Top-Down Cognitive Rehabilitation Therapy
The top-down approach uses the exact opposite method in therapy sessions. With top-down CRT, higher-order thinking is emphasized through healing activities, based on the belief that basic cognitive abilities will be improved as a repercussion.
Providers who use top-down CRT methods will often emphasize cognitive exercises that directly relate to contexts relevant to the patient’s daily life. This may involve their family life, social life, or their job. The top-down theory believes that by integrating these holistic elements of the patient’s life in their treatment, basic cognitive skills will come naturally as a byproduct.
Are Cognitive Rehabilitation And Cognitive Training Helpful?
In 2019, a systematic metanalysis ( a review combining over 121 scientific studies ), concluded that CRT is highly beneficial for those suffering from a concussion, TBI, or stroke. Following these original studies, an additional systematic review on the efficacy of CRT was published in August 2022. These studies concluded that CRT is highly effective for patients battling Alzheimer’s disease or suffering from dementia.
Overall, research shows that cognitive rehabilitation and cognitive training are revolutionary methods that can help patients as they work to restore optimal brain and cognitive functioning over time. In order to be certain that you’re seeing a cognitive trainer with the right training, make sure they’ve received training from a credible organization such as the American Congress of Rehabilitation Medicine.