Cognitive Rehabilitation

Cognitive rehabilitation was once reserved only for people with traumatic brain injuries.  Now we know that people with other cognitive changes can benefit.  There are generally two approaches to cognitive rehabilitation: (1) compensatory and (2) restorative or capacity building.  However, a holistic, person-centered approach to cognitive rehabilitation also helps people learn skills that can positively impact cognition and thinking, as well as navigate the complex emotional journey that often accompanies changes to the brain and mind.

The CBMM RENEW (REsilience through Neurologic and Emotional Wellness) Program offers a range of programs focused that help people learn new skills, build capacity (when possible), optimize lifestyle factors, and move toward emotional resilience.  These programs take place in groups so participants can learn from both the facilitator and others going through similar cognitive changes.  See below for details on current programs.

For more information on RENEW programs, email brainhealthgroups@bwh.harvard.edu or ask your CBMM provider for a referral.

Compensatory Skills Training

• Goal Management Training – This nine-week program covers the importance of mindset, improving task focus and performance monitoring, supporting working memory, overcoming procrastination, and improving decision making.  Motivation is key to planning and organizing, and is incorporated into this program by exploring values and thinking about long-term goals.  This program establishes skills to build awareness, understanding, and acceptance of goal-management problems and then develop specific strategies to target them.  Mindfulness exercises are also taught to strengthen attention.

• Memory Skills Training – This six-week education and support group focuses on improving your ability to learn and retain new information to mitigate the impact of memory loss on daily life.  We start with an overview of how memory is organized in the brain, then learn practical strategies and lifestyle modifications that support brain health.  This program seeks to support memory improvement, which in turn enhances confidence and emotional well-being.

• Mindfulness Attention Training  – This seven-week program teaches mindfulness-based strategies to manage stress, improve attention, and support overall well-being.  Topics include mindfulness and compassion, loving-kindness, and strategies to interrupt autopilot and cultivate present-focused, nonjudgmental awareness.  Each week, we discuss and practice specific strategies, which participants can practice on their own using audio files and incorporate into their daily lives.  Participants are introduced to a wide range of mindfulness-based practices, informal and formal, to build and tailor personal practice.

Lifestyle & Wellness Programs

Lifestyle and wellness programs teach people how to support brain health by making shifts in diet, exercise, and sleep.  Research shows we can change the course of brain disease by following certain guidelines.  Enhancing social and cognitive stimulation is also a priority, as well as learning strategies and techniques to transform changes into habits.  We currently offer the following programs:

• My Healthy Brain –  This group-based lifestyle program was designed by our colleagues at Mass General Hospital (MGH) to promote brain health in older adults with cognitive decline.  The eight-week program consists of weekly 90-minute sessions that target modifiable risk factors for dementia, including lack of physical activity, social activity, poor sleep, use of alcohol, and diet.  CBMM offers this program twice per year: in the Spring and Fall.

• Cognitive Behavioral Therapy for Insomnia (CBT-i) – This seven-week program includes interventions designed to improve sleep quality and reduce thoughts, feelings, and behaviors that interfere with sleep.  Behavioral interventions include sleep consolidation/restriction, stimulus control, and sleep hygiene.  Unhelpful thoughts and beliefs about sleep are addressed through cognitive restructuring, mindfulness, and breathing techniques.  Participants are asked to track their sleep patterns using a sleep diary.
• RENEW Book Club – Once you participate in a RENEW group, you are eligible to join the Book Club.  We read books on the brain, neuroplasticity, and well-being, and then meet weekly to discuss one to two chapters.  This is a free community program and is not billed to health insurance.  Book club is a powerful source of both cognitive and social stimulation.  Here are some books we’ve read in past sessions:
  • Altered Traits: Science Reveals How Meditation Changes Your Mind, Brain, and Body by Daniel Goleman and Richard Davidson
  • The Brain That Changes Itself by Norman Doidge
  • The Brain’s Way of Healing by Norman Doidge
  • The Emotional Life of Your Brain by Richard Davidson and Sharon Begley
  • Incognito: The Secret Lives of The Brain by David Eagleman
  • Livewired: The Inside Story of The Ever-Changing Brain by David Eagleman
  • The Man Who Mistook His Wife for a Hat by Oliver Sacks
  • The Seven Sins of Memory by Daniel Schacter
  • Stolen Focus by Johann Hari
  • Unthinkable by Helen Thomson

Emotional Resilience

Emotional resilience programs recognize that changes to the brain not only impact cognitive functioning, but can turn our emotional world upside down.  Many experience some degree of depression and anxiety.  Adjusting to brain changes can disrupt how you feel about yourself, and cause  feelings of shame and loss.  Over the next year, RENEW will offer two new programs focused on serving the emotional needs of our community.  Please check back for updates on these programs:

• EmReg Training – This program is designed for people who have had a change in brain functioning and provides skills to better manage emotions day to day.  EmReg stands for Emotion Regulation and the goal is to better identify and influence emotions.
• Brain ACT (currently in development) – Acceptance and Commitment Therapy (ACT) uses commitment and behavior change strategies to increase psychological flexibility through six core processes: acceptance (accepting positive and negative thoughts about situations you cannot change), defusion (disentangling thoughts), sense of self (separating the self from the process of thinking), mindfulness (focusing on the present moment), valued living (being aware of what really matters), and committed action (taking action guided by your values).