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

A great deal of research has shown that good thinking skills are important for success in daily living including positive interactions with friends and achievement at work or school. The restorative approach to improving thinking skills involves, as its name suggests, restoring an individual’s thinking skills to a level he or she had prior to experiencing an illness. This is thought to be accomplished by restoring the functioning of the brain-neuron connections that underlie impaired thinking skills. The restorative approach takes advantage of “brain plasticity” which refers to the brain’s amazing ability to modify these connections and re-wire itself. The initial phase of a restorative program involves improving basic thinking skills such as concentration and short-term memory. The individual builds these skills through “drill and practice” before moving on to higher level skills such as 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-like” and self-paced, yet some training experts believe that a thinking skills coach is needed to help the individual apply the skills learned from the computer games to improve functioning in daily life. If a thinking skills coach is needed, that coach can work with several participants simultaneously or individually. There is scientific evidence that the approach works for improving thinking skills. However, critics point out that although individuals improve on the computer games, the skills learned might not transfer to improvements in daily life activities.

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