Many medical problems, such as traumatic brain injuries, stroke, dementia, and even cancer, can affect the brain and make it difficult for someone to think or process information.
Cognitive rehabilitation therapy refers to a group of treatments that help improve a person’s ability to think after a brain injury or illness that affects the brain.
Cognitive rehab therapy includes a variety of methods and approaches. They all aim to restore cognitive function. Cognitive function includes skills like attention, memory, processing speed, problem-solving, and multitasking.
In cognitive rehab therapy, medical experts, such as therapists and psychologists, work together to come up with a plan to restore as much cognitive function as possible based on your personal needs and goals.
During cognitive rehab, therapists and psychiatrists use different methods, techniques, and tools to help improve your cognitive abilities. These might be done during individual or group sessions guided by a therapist, online programs, or a combination of these.
There’s no one-size-fits-all approach to cognitive rehab. The type of exercises and tasks you’ll perform will be tailored to your needs. Depending on your specific needs, treatment might aim to improve one or more of the
- problem-solving skills
- ability to multitask
- processing speed
- decision making skills
- communication (written, speech, language, etc.)
Cognitive rehab is based on the concept of neuroplasticity — that the brain can change and adjust throughout life by strengthening existing connections or creating new ones.
In general, there are two types of cognitive rehab:
- Restorative treatment: You’ll practice skills to improve them. Examples include memory exercises, problem-solving games, and mental exercises aimed at improving attention span.
- Compensatory treatment: You’ll learn how to work around your deficits or injuries. This includes using smartphones, calendars, memory tools, and devices, and setting alarms to help compensate for reduced cognitive function.
By improving cognitive abilities, cognitive rehab makes it easier to manage and perform everyday activities. It may also help you:
- improve social relationships
- live more independently
- enhance your ability to communicate with others through written or spoken language
- multitask and stay organized
- perform better at work
- make decisions
Studies involving people with multiple sclerosis (MS) suggest that cognitive rehab can also help someone gain a better understanding of their illness. It can increase their confidence and optimism in overcoming that illness and have an overall positive impact on their quality of life.
TBI usually occurs after an accident involving a bump or jolt to the head. Stroke is when the blood supply to the brain is cut off for a period of time.
But there’s evidence that the various types of cognitive rehab techniques can also help with other illnesses that affect the brain, such as:
- bipolar disorder
- Alzheimer’s disease
- Parkinson’s disease
- obsessive-compulsive disorder (OCD)
- executive dysfunction
- attention deficit hyperactivity disorder (ADHD)
- multiple sclerosis (MS)
- long COVID
- cognitive dysfunction caused by cancer or treatment for cancer
- cognitive dysfunction caused by brain surgery
Cognitive remediation vs. cognitive rehabilitation
Cognitive remediation is a type of cognitive rehab, but the terms are often used interchangeably. Cognitive remediation might also be called cognitive enhancement or cognitive training.
Both cognitive remediation and cognitive rehab are different from cognitive behavioral therapy (CBT). CBT is a treatment approach that helps you think through emotional and psychiatric problems, whereas cognitive rehab and remediation help improve the underlying functions that help you think.
Any technique or strategy that helps improve cognitive function following an injury or illness to the brain can be considered a type of cognitive rehab.
These techniques may be focused on improving a specific cognitive function. They may be restorative or compensatory.
Some examples of strategies used during cognitive rehab
- neurofeedback, also called electroencephalogram (EEG) biofeedback, which allows you to see your own brain waves on a computer monitor as you perform tasks to help you recognize and regulate your brain function
- attention processing training (APT), which involves exercises to help you focus and ignore distractions
- virtual reality, which can provide sensory stimulation and real-time feedback when doing specific motor tasks
- using external assistive devices
- speech-language therapy exercises for speech or language problems
- occupational therapy for help with daily or work tasks
- computer-assisted training programs
- using smartphones and GPS devices to help with daily living and task organization
The type of cognitive rehab exercises your care team uses in your treatment plan will depend on your specific needs.
For example, after a brain injury, you might find yourself easily distracted, unable to complete tasks quickly, and having trouble with your memory.
As part of restorative treatment, you might perform some memory exercises using special computer software or written worksheets to challenge your memory.
Other examples of rehab exercises in restorative cognitive rehab therapy include:
- problem-solving games
- motor dexterity tasks
- reading information out loud or creating a story containing the information to help you learn it more quickly
You might have to repeat a series of tasks that gradually increase in difficulty over time.
As part of compensatory treatment, you might learn how to use a daily planner on your smartphone and set reminders that help you stay focused and break down tasks.
Other examples of compensatory cognitive rehab therapy tasks include:
- using assistive speech devices to help with a speech impairment
- learning memory tools
- setting alarms that help you regain lost attention or remember important events
A 2019 systematic review of 121 studies evaluated by the Cognitive Rehabilitation Task Force found substantial evidence to support cognitive rehab after TBI or stroke.
But current evidence across other conditions is limited. Individual studies across other conditions are often small or personalized for people with different clinical conditions with unique goals and objectives.
There are no current guidelines for selecting the most effective cognitive rehab treatments for each specific person. More research is needed to understand the effectiveness of each type of rehab therapy and the conditions in which they are most beneficial.
How to find a cognitive rehabilitation therapist
Depending on your needs, you might receive cognitive rehab therapy from a:
- speech therapist
- occupational therapist
- neurofeedback practitioner
- physical therapist
- cognitive remediation therapist
- rehabilitation psychologist with specialized training
Ask your primary care doctor for a referral to a specialist in these areas. A local cognitive rehab therapist might be difficult to find, but the field is rapidly growing.
You can try searching for a therapist who takes your insurance using Healthline’s FindCare tool.
Cognitive rehabilitation is a useful and effective therapy to help people with brain injuries and illnesses improve their ability to think. During cognitive rehab therapy, you might practice skills to improve cognitive deficiencies or learn techniques to help you work around these issues.
If you’re interested in cognitive rehab therapy, speak with your doctor about your options. You can ask for a referral to a therapist or other healthcare professional who specializes in this type of treatment.