With cognitive remediation therapy, connecting the dots with your patient is key to success

Bridge Skills to Daily Life

Digital tools like HappyNeuron Pro provide a platform to practice cognitive skills, but you have to help your patients understand the purpose of their practice and how it transfers into everyday life.

The transfer of skills from one setting into another is called generalization. The process that fosters behavior change following cognitive intervention is called bridging.

Bridging aims to achieve generalization, but can only do so with guidance from the therapist.

Choose the right HappyNeuron Pro Exercises

With HappyNeuron Pro, you can select exercises for your patients to perform at home and in the clinic. For example, your patient may tell you: “I have trouble remembering faces and names. It’s hard for me to go to family events because I get distracted and overwhelmed seeing people because I don’t remember their names or things about them”.

This patient is describing deficits in executive function, visual and auditory memory, and attention. HappyNeuron Pro offers exercises that target these areas. A sample workout plan from HappyNeuron Pro that can be used to improve these cognitive skills would include exercises such as I Remember You!. Gulf Stream, You’ve Got Voicemail!, Hurray for Change!, An American in Paris, and Two-Timing. While this is a short-workout plan, HappyNeuron Pro offers a variety of exercises that you can use with your patients to target various domains of cognition.

Screenshot of HappyNeuron Pro exercise I Remember You

Introduce and Discuss the Tasks

Taking the above workout plan, you would have your patient do these exercises under your supervision first. Discuss how they would approach each one, what strategies are they using to complete the exercises, what did they enjoy, and what did they think they can do better on.

You would then send them home to practice on their own and review their results from their home practice.

Along with your notes and their results, you can see where your patient is having difficulty and tailor your treatment plan to target those problem areas.

Help Bridge to Real Life

Once they have started to get into the rhythm of practicing and are starting to have a stronger foundation, your next step is to bridge what they are practicing into real life. You can do this by creating mock scenarios, such as a party, or by exposing them to an environment where they would have to use the skills they are building at home.

Bridging will look different for individual and group sessions, as there is more you can do when you work with multiple people at a time.

Family Event

In a group, you can set up a mock party scenario and have participants share their name, where they are from, and their favorite color. Each participant would be asked to share details about a person they had not met before. You would then discuss what strategies they used to remember the person’s name, what their favorite color was, and how did they remember the face that corresponds to the name of the person they interacted with. Every participant would share their strategies, and you would guide each person on developing an effective plan to retain information from people they meet in the real world.

On an individual basis, you could have your patient watch a short film or show they are unfamiliar with that pertains to an area of interest they have. They would be tasked with having to show you and identify the names of 3 characters in the show and give three facts about those characters.

With bridging, you must get creative and replicate scenarios your patient would experience in their daily life.

For guidance on bridging, you can purchase Alice Medalia and Chris Bowie’s guide Cognitive Remediation To Improve Functional Outcomes.

Consolidate After Bridging

After bridging activities are completed, it is important to reflect on what was done prior to the exercise, during the exercise, and what would be done afterwards for optimal outcomes. This allows the patient and therapist to reflect on how to proceed with therapy and adjust treatment plans as necessary.

HappyNeuron Pro can be part of your therapeutic toolkit as you conduct cognitive remediation therapy in your setting. What is important is that your provide opportunity and guidance for your patients to connect what they are doing in HappyNeuron Pro to their own lives. Bridging is the process that allows for this, with you as the designer and executor of how your patients will practice and translate skills they learn with you into the real-world.

Bridging Session

Page last updated on Jul 10,2019

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