What Is Cognitive Rehabilitation for Cognitive Deficits?

Cognitive rehabilitation for cognitive deficits is complex, but today it's used in many types of mental therapy. Keep reading.

Written and verified by la psicóloga Leticia Aguilar Iborra.

Last update: 16 January, 2023

Cognitive rehabilitation is a new field. It refers to the different methods that are used to compensate for or improve cognitive deficits that occur as a consequence of certain alterations produced by brain injuries or diseases that influence cognitive functioning at an optimal level.

In this regard, cognitive rehabilitation not only achieves improvements at the brain level and, therefore, performance. It also achieves improvements in the social, family, personal, and academic areas. The importance of cognitive rehabilitation is considerable, as the improvement in the quality of life of many people depends on it.

What’s cognitive rehabilitation for cognitive deficits?

Cognitive rehabilitation is understood to be the “set of procedures and techniques whose primary objective is to achieve improvements both in the cognitive performance of the person, as well as in other areas of interest surrounding the individual (social, family and work area).”

Therefore, the adaptation to this and the improvement of the individual’s functioning is improved as the objective of achieving a certain degree of autonomy, not to mention the increase in the level of quality of life.

There are different mechanisms for cognitive rehabilitation that are sometimes related. In some cases, cognitive rehabilitation programs may include more than one modality, converging between some mechanisms and others.

Stimulation mechanisms

• Restoration: Used when there’s a partial loss or a significant decrease in performance in a specific area. Here, repetition exercises are usually performed to generalize the consultation training to real life. An example of this would be in the case of memory problems.
• Compensation: An attempt is made to promote the use of other mechanisms such as compensation for an affected area that can’t be restored. Preserved abilities enhancement is used as a way to compensate for the limitations of the area that’s affected.
• Substitution: The person is taught to use different strategies as a way to minimize the difficulties caused by the affected area. Alternatives are used with tools from abroad (use of calendars, photographs, clocks, alarms, etc.)
• Activation-stimulation: This manifests as a slowdown in information processing. Triggering strategies are used as a way to release blocked areas to their highest form. An example can be summarized in the use of psychotropic drugs, behavior modification, or repetition strategies in the face of a specific stimulus.
• Integration: This is about improving mental activity in a global way. Therefore, it aims at eliminating interferences in information processing by working in a holistic way.

Other modalities

In addition to the previous points, cognitive rehabilitation also uses the following modalities:

• Surgery: Replacement of damaged brain tissue. It’s applied in the treatment of degenerative diseases such as Parkinson’s disease or Huntington’s chorea.
• Psychopharmacology: The use of drugs that improve cognition by correcting chemical imbalances. It also alludes to the importance of nutrition in certain cases, as some diseases are also correlated with malnutrition, such as advanced-stage Alzheimer’s disease.
• Improvement of other important areas of the individual: The lifestyle of the individual is very important, and efforts shouldn’t be spared for a correct approach to their emotional and social health.

Who’s it aimed at?

The population targeted by cognitive rehabilitation is broad and diverse. It’s true that each person is different and each of them will need a concise program to suit their needs, so all rehabilitation is tailored to the needs of each of the people who undergo treatment.

In general, the benefits that are achieved with cognitive rehabilitation for cognitive deficits are improvements in memory, attention, level of processing, speed of reaction to stimuli, problem-solving, etc. Therefore, cognitive stimulation is usually focused on the following individuals:

• People with acquired or congenital brain damage
• Neurodegenerative diseases: Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, Lewy body dementia, frontotemporal dementia, etc.
• Mental disorders or mood disorders: Chronic depression, bipolar disorder, etc.
• Neurodevelopmental disorders: Attention deficit hyperactivity disorder (ADHD) or autism, etc.

Some basic characteristics before starting cognitive rehabilitation

As stated in the previous point, cognitive rehabilitation must be individualized and tailored to the specific needs of the person.

For example, people with acquired brain damage constitute a very heterogeneous group, even the way they acquire the damage can vary due to external accidents (for example, blows) to internal processes (brain hemorrhages, ischemias, etc.).

In this regard, the level of awareness of the damage must be taken into account as well and then the initiation and regulation of behaviors that are in line with the rehabilitation process will begin.

In addition, family members and therapists are also important figures. That is, it’s not only the professional’s job to implement training tasks that can be generalized to real life, but also the help of their immediate environment is needed to generalize the skills trained.

In this regard, rehabilitation isn’t only focused on improving the deficits that the person has, but it must also produce changes in the social sphere so that the level of adaptation and quality of life increases.

Specialized learning techniques

In general, most rehabilitation programs have the acquisition of new information by individuals who are directed to tasks of cognitive stimulation. In this regard, it’s important to identify and use techniques that have been shown to be effective in people with brain damage. Some examples are:

• Direct learning techniques: Carried out to strengthen basic academic skills. Strategies are used such as dividing a complex task into subtasks that are less difficult, relating new learning to previous experiences, using feedback from the therapist, etc.
• Error-free learning: This is a direct learning technique that has been shown to be effective with individuals with severe memory problems. It consists of offering the correct answers to the task until the person can consolidate this new information. An example of this is learning and associating names with faces, initiating sequences of behaviors, etc.
• Procedural learning: This occurs through repetition and takes some time. However, people with severe memory deficits benefit from these types of repetition-based techniques.

A complex but useful technique

In short, there’s a wide range of cognitive rehabilitation programs according to the needs of each individual. Thus, people with cognitive deficits can show improvements once they start this type of procedure.

The benefits are clear, however, the emotional, family, and social sphere of each person who undergoes this type of process shouldn’t be forgotten.

The objective of this treatment goes beyond the physical, including another type of functionality in the way of relating to the outside world.