Frequently Asked Questions
- What does cognitive remediation, retraining or rehabilitation entail?
Changing the way you think, function and behave can be made possible with introspection and practice. Some people are able to achieve that by working on themselves while others need more guided practice and strategic support. In the field of rehabilitation, this process is described as "cognitive retraining" and can be interchangeably used with "executive function training" or "cognitive remediation."
In general, it involves enhancement or restoration of cognitive functions that are either developing slower than expected or are lost due to an injury to the brain. This is, in essence, a process of learning and rebuilding skills by having an individual engage in three specific processes:
- Metacognitive training (process of introspections)
- Exercise-based enhancement of underlying thinking ability or functions and
- Use of strategy-based support to allow for maintenance of functional outcomes
- I am interested in knowing how your service will benefit my child, relative or myself. What do you suggest?
- First of all, I encourage you to navigate through my website which is pretty comprehensive and well-organized. After which you can call me (at 404-493-0962) or email me (at email@example.com) to speak with me further to decide ways in which I could be of assistance to you. Finally, we can go ahead and schedule an evaluation to the assess cognitive-linguistic and executive skills pertinent to becoming self-sufficient and effective.
- How long does it take?
- The duration of treatment is variable with the process ranging from 6-12 months. This is because no two individuals share an identical profile with respect to executive functioning ability. Also, the need and emphasis of treatment is very much dependent on functional impairment for that individual. We work on what seems to be interfering the most. In some cases treatment can take longer or in other cases it can be completed sooner. In several cases I work with students and then they return after a few years as their academic demands change.
- Who will be working with my child or the patient?
- In my practice I am the sole practitioner and hence I conduct the evaluations as well as the treatment sessions.
- What does training involve?
In general, the step-by-step procedures involved in cognitive retraining may include some or many of the following elements:
- identification of weaknesses
- acknowledgment and/or process of generating goals,
- self-monitoring and
- predicting performance accuracy
- self-recording various aspects of performance
- engagement in making strategy decisions based on the performance
- connecting a goal to overarching goals
- comparison in which individuals adjust the plan based on self-feedback or external feedback.
- What are the ways to optimize the therapy outcome?
- I find that a decent balance between faith in the clinician and commitment to the process of "deliberate and intentional learning" is a great starting point. It is ironic but true that individuals with executive dysfunction are unaware of their deficits and hence are unaware of the "need" for change. People in their environment are more motivated to see the change than the individuals themselves. I often notice that this lack of insight on a student's or patient's part can become a huge sore point. This creates a great sense of frustration and irritation on the part of loved ones who believe in intervention. I suggest that carefully tempered expectations and consistent follow through with recommendations are fundamental stepping-stones of optimization of therapy.
- How frequently does one need to participate in the training?
- In order for the therapeutic process to be effective, a once a weeek pace or frequency is recommended. In case of patients with a brain injury, I recommend even more intense work. People have asked me if once a month or once in a while frequency would have any impact on cognitive learning and carryover. I am skeptical of any such recommendation. New ways of thinking requires the facilitation of a gradual shift in beliefs, behaviors and communication. This can be successfully attained with practice and frequent redirection. Working with an expert such as myself who can observe your learning process and tweak your follow-up can actually enhance retention and eventual transfer of new learning.
- When working with students, do you work with schools/teachers/other professionals involved in care?
- It is quite true that it takes a village to change our ways of doing, thinking and being. Several aspects of this type of executive training are founded in observational feedback. I find it extremely useful to know how others view the student's or patient's behavior in non-therapeutic contexts (outside the four walls of my office). Thus feedback can help me tremendously in redirecting the therapeutic emphasis. I also consider it to be a valuable process to inform others regarding the nature and scope of executive dysfunction as it pertains to the student or patient I am working with. It is hard to empathize with someone who is known to be capable yet underachieving. I like when the family members or parents or patient themself provides me with appropriate contact with all the necessary people involved so we can work together on the care.
- What role do parents play in the cognitive training or executive function training process?
For younger students (elementary age) I recommend that parents take an active part in the therapeutic process. Occasionally, I suggest that parents participate in and observe the training process to learn effective ways of redirecting their child at home. It is also important that parents learn ways to change their communication style to provoke thoughts related to self-administration.
For older students and for spouses or parents of adult patients I recommend that they meet with me in a separate session to discuss goals, process and strategies. I welcome email and voicemail feedback and of course, I am available to discuss issues over the phone.
- Does one need to be diagnosed with ADHD or TBI to be working with Sucheta?
- Most often people who seek services are those who are experiencing some genuine interruptions in their personal, academic or professional life on a regular basis. Some of these interruptions are clearly explained by a notable or a diagnosable entity while with others, the symptoms are more tangible than the underpinnings of such symptoms. I believe cognitive retraining or training one's brain in general can lead to enhancement of functioning. So the answer is no, you do not need a diagnosis to work with me.
- Do you prescribe medication?
- I am not a medical doctor and hence no, I do not prescribe medication.
- Do you take insurance?
- We do not directly deal with or file insurance for patients. However, we will provide you with invoices and any paperwork or reports your insurance may require.
- What should I do next?
- Please send me an email at firstname.lastname@example.org with your inquiry and I will follow-up with a phone call to determine next steps, which may include an initial consultation.