Bringing Cognitive Remediation to British Columbia

July 14th, 2021   |   By BCSS Communications

By Dr. Mahesh Menon and Susan Inman

Families often learn very little about the cognitive losses associated with illnesses like schizophrenia. These losses are considered one of the biggest factors in the widespread disability of this population. As well, people with these disorders and their family members are rarely informed, assessed, or provided with treatment for problems relating to cognition.

In 2017, BC Schizophrenia Society worked with the BC Psychosis Program, BC Early Psychosis Intervention, and BC Psychosocial Rehabilitation to organize a conference featuring international leaders in the field of cognitive remediation. The response to this sold-out event was very positive; the conference organizers created a working group with the goal of making cognitive remediation programs available to families across BC.

Numerous studies and meta-analyses have shown that Cognitive Remediation Training (CRT) improves cognition and functioning for individuals with schizophrenia spectrum disorders. An effective CRT program includes at least four key components:

  1. cognitive exercises (e.g. on a computer program), which include different exercises that target domains of cognition such as memory, attention and executive function;
  2. trained therapists who can help facilitate discussion in order to allow participants to
  3. identify and develop problem-solving strategies, that can
  4. be transferred to real-world functioning.

Action Based Cognitive Remediation (ABCR) is an innovative program developed by Prof. Christopher Bowie, a psychologist based at Queen’s University in Kingston. ABCR includes computer exercises and versions of ‘real world’ transfer tasks that participants can carry out in the group to facilitate strategy utilization.

In October 2020, Dr. Menon and Dr. Bowie carried out a four-week ABCR training session for more than 60 therapists (from a range of training backgrounds, including psychologists, occupational therapists, social workers, and nurses) from across BC. These trained therapists are now in the process of getting the computers, licenses, and materials to start groups in their home communities and will be accepting referrals and contacting individuals who may be interested in CRT.

Prior to starting the groups, they will complete a brief cognitive screening session with interested participants to identify their strengths and weaknesses in different domains of cognition. Due to the pandemic, some of the groups will be run remotely on Zoom while others may be in person.

Dr. Menon and Dr. Bowie have also been carrying out consultation sessions as therapists get started on running CRT groups in their home communities. They are excited to see the enthusiasm of both the therapists and participants from different BC health authorities who are engaging in this program. 

Families can play a vital role in persuading service providers to implement cognitive remediation programs. Many family members who need these programs aren’t in a position to advocate for them. However, if we want to see these vital resources incorporated into treatment options for people with mental illnesses, our advocacy could be crucial.

There are several ways you can help support a better understanding of cognitive losses and assist in the implementation of CRT in BC.

Learn about the cognitive losses impacting people living with serious mental illness, like schizophrenia. Share educational resources with others, including your family member’s service provider. Ask your local mental health system to make CRT available to the many people who need it.

Resources

List of Cognitive Remediation Programs (Current and Future)

Vancouver Island Health Authority

  1. Victoria (Island Health Mental Wellness Day Program): This is a virtual group, which is open to Victoria EPI clients. Contact: Lauren.Fox@viha.ca
  2. Cowichan Lodge: This will be an in-person group for residents of Cowichan only. 
  3. Parksville/Oceanside: There may be a group starting here. The OT has been doing ABCR 1:1 with some clients. Contact: Alison.Drennan@viha.ca

Interior Health

  1. Penticton (Penticton MHSU/South Okanagan): This will be an in-person group open to clients in the South Okanagan starting in September. Contacts: Jesse.Giddens@interiorhealth.ca or Sarah.Senecal@interiorhealth.ca
  2. Kelowna (Cara Centre): This is an in-person group, open only to residents in the Cara Centre. This group may also be extended to clients at the Kelowna General Hospital Inpatient unit. Contact: Pamella.Rees@interiorhealth.ca
  3. Kamloops (CMHA Clubhouse, 857 Seymour St): In-person (and limited size for the first group). Groups will be Mon & Wed from 2-4 pm for 8 weeks starting in late September. Contacts: Jen.Sheeley@interiorhealth.ca or Laurie.Kitamura@interiorhealth.ca, or call Kamloops Mental Health and Substance Use at 250-377-6500 and ask to speak with either Jen or Laurie.

Fraser Health

  1. Timber Creek: There will be an in-person group starting in August for inpatients at Timber Creek. Contact: Qun.Ma@fraserhealth.ca