The Cognitive Restorative Strategies (CRS) are more than 25 years of my personal work as a clinical neuropsychologist. The CRS is used with individuals who have adjustable and repairable organs, which is widely misunderstood by common Western approaches within the field of neurology. The brain is born with a number of specific modules, which include the motor and vision areas. These areas are universal in their functions and locations. The CRS is the degree to which each cognitive module grows, becomes efficient and interacts with other modules. This is subject to the harmony and collaborative relationship among and between the modules, as well as social cultural influences.
The Western models identify the brain modules as a set of capacities that flourish over time, reaches its peak, plateaus and then decays in old age. In this model, the greater functional capacities are achieved only when the modules are at their maximum level of functioning and processes. Accordingly, the maximum level is obtained only at youth. This model is based on an “additive” assumption; therefore, subtraction of each module from the total functional equation leads to the total collapse of the system. Therefore, in order to bring the brain to its full capacity, we need to replace the module with similar modules. This assumption, in terms of brain rehabilitations poses at least two problems:
1.) The replacement needs to be in place for compensatory processes to take place. 2.) The older individuals will not recover to their functioning level, since they are in the disadvantageous condition of not having their brain modules fully functional. Contrary to the above perspective, the CRS, assumes that all modules grow harmoniously and exchange information between them. The brain functional capacities are therefore maximized when the harmony and collaborations between the modules have been maximized, and not when one module reaches the highest level of functioning. Additionally, optimum functionality is achieved when social and cultural factors continue to remain compatible forces nurturing the brain modules. In the current state of affairs, our culture, as well as the compensatory model, maintain that there are at least two elements that work against those with any type of brain dysfunction or less than ideal level of brain functioning. 1.) The inadequacy in one or more modules restricts their potential functioning 2.) The cultural environmental forces pose negative perspectives leading to the development of less than ideal changes in the affected modules.
The Cognitive Restorative Strategies (CRS) is designed based on the premise that restorative processes have proven to be more effective than compensatory processes and other rehabilitation methodologies in preserving cognitive and emotional well being of those who have suffered from various types of cognitive losses due to brain injuries caused by damage to specifically vital memory centers of the brain, that prevents the formulation of retrieval strategies or complete information processing. The CRS is also designed for the people with “incidental” forgetfulness. These individuals might suffer from losses of information occurring in multiple stimulation situations. These people complain about keeping up with the irritation associated with remembering what they need to do or what is referred to as. “executive” dysfunction. The CRS aims to enable people with mild cognitive impairment, mild and early phase of dementia, including the early phase of Alzheimer’s disease and stroke to achieve their optimum level of well being. The CRS works to reduce the functional disability resulting from damage to the brain caused by progressive brain disorders such as dementia or localized brain damage, caused by strokes or mini strokes. The neurobehavioral underpinning of the CRS is restorative of functions via enhancing brain elasticity to rewire itself, in order to deliver the needed function. Central to this process is the collaborative identification of personally meaningful goals, and the development of interventions to address these goals. CRS interventions draw upon a mixture of approaches aimed at restoration of function, implementation of compensatory strategies and environmental modification. No cognitive restorative strategy is successful unless it takes into account the emotional responses to cognitive impairment, and the psychosocial difficulties that follow cognitive losses.
The aim of the psychosocial training of the CRS is to enhance participants’ self-esteem and build confidence in their ability to respond to cognitive challenges put before them on a daily basis. The CRS uses strategies such as general cognitive stimulation including prompting recall of remote memory, practicing conversation skills, problem solving, reading and creative activities, computerized visiospatial drills and memory drills in order to achieve the best possible outcome for the client.
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