How does the restorative approach work to improve cognitive functioning in individuals with SMI?

The restorative approach to cognitive remediation involves, as its name suggests, restoring individuals with SMI to premorbid levels of cognitive functioning. This is thought to be accomplished by restoring the functioning of brain neuronal circuitry that underlies impaired cognition. The restorative approach takes advantage of a phenomenon called “brain plasticity” which refers to the brain’s amazing ability to modify neuronal connections and re-wire itself. The initial phase of a restorative program involves remediating fundamental cognitive skills such as concentration and working memory. The individual builds these skills through “drill and practice” before moving on to higher level skills such as abstraction, reasoning, and problem-solving. Given that most restorative programs are computerized, they can be found on-line by searching titles such as BrainHQ, Lumosity, Happy Neuron, and Brain Safari. Generally, these programs were designed to be “game-line” and self-paced, yet some cognitive training experts believe that a cognitive coach is required to help the individual generalize learning to daily functioning. If a cognitive coach is needed, he or she can work with several participants simultaneously or individually. There is scientific evidence that the approach works for improving cognitive functioning. However, critics point out that although individuals can improve on the training tasks, the skills learned might not transfer to improvements in daily functioning. Click her for a review on this topic.

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