Is Cognitive Stimulation Therapy Effective?
- Orlando Ely
- Jan 15
- 5 min read
Updated: Jan 19
Blossom was developed to stimulate cognition as much as train fine motor skills and “can be integrated into Maintenance Cognitive Stimulation Therapy for dementia sufferers and Physical, Occupational and Therapeutic therapies for stroke patients, and other neurological diagnoses such as spinal cord injury, peripheral nerve injury and MS.” (Occupational Therapist at Hobbs Rehabilitation)
A summary of the MODEM report on the effectiveness of cognitive stimulation therapies:
MODEM (Modelling Outcomes and Costs Impacts of Interventions for Dementia) project 2014-2018 was funded by the UK Economic and Social Research Council (ESRC) and the National Institute for Health Research (NIHR). (Led by the London School of Economics and Newcastle University Institute for Ageing.)
Cognitive skills are the skills the brain uses to think, learn, remember, problem solve and communicate. There are a number of approaches to help people with dementia improve their memory and thinking skills and to cope with memory loss, one of these is Cognitive Stimulation Therapy (CST).
Key points:
CST helps the memory and thinking (cognitive) skills of people with mild to moderate dementia
people with dementia who took part in CST said that there was an improvement in the quality of their daily life
CST offers value for money (is cost effective because it works)
National Institute for Health and Care Excellence (NICE) and Social Care Institute for Excellence (SCIE) guidance (2006) recommends that people with mild to moderate dementia should be given the opportunity to take part in a CST programme
What is Cognitive Stimulation Therapy?
Cognitive Stimulation Therapy involves 14 sessions of structured 45 minute group therapy sessions. The sessions run over 7 weeks and each one covers a different topic. To ensure continuity between the sessions they include some activities which are the same, such as a warm-up activity, a song and a ‘reality orientation board’ which has information on the group, and details of date, time, place, weather.
Members give their group a name and sessions cover a range of activities to stimulate thinking, memory and to connect with others:
Discussing current news stories
Listening to music or singing
Playing word games
Doing a practical activity e.g. baking which involves measuring ingredients and following a recipe
The sessions are intended for people with mild to moderate dementia. They are designed to be relaxed, fun and to create opportunities for people to learn, express their views and work with others in a sociable setting.
Why is Cognitive Stimulation Therapy important?
Many people with dementia want to find ways to improve their memory and thinking skills and cope with memory loss. While there are some drugs that help people in some stages of Alzheimer’s disease, they are not suitable for everybody and only have a limited effect.
CST is important because, as well as stimulating the mind, the group sessions offer an opportunity to share experiences and talk with other people with dementia in a relaxed and supportive environment. Being part of the group helps to their build self esteem so they feel better about themselves and more confident to join in conversations and activities.
Does Cognitive Stimulation Therapy work?
Improved cognitive skills and quality of life
CST has been found to significantly benefit the memory and thinking skills of most people with mild to moderate dementia.[2,5] People with dementia who took part in the therapy programme said that there was an improvement in the quality of their daily life.[13] Some carers and relatives said that there was an improvement in language and the willingness of people with dementia to join in conversations.[12]
These findings are based on two studies, in the first one, a randomised controlled trial (RCT)[2] the people taking part were put into two groups by a computer. The first group took part in CST in addition to being given their normal care. The second group were given their normal care. In this trial most of the people with dementia were living in care homes. Its findings were confirmed by a second study[5] where half of the people were living in their own home and half in care homes. The first trial[2] found that CST worked as well as drugs commonly prescribed for mild to moderate Alzheimer’ s disease (usually donepezil) and the second study[5] that CST had benefits for people in addition to the benefits from taking the medication.
Smaller pilot studies of adapted versions of CST in Chile and Japan have also reported benefits in memory and thinking skills and quality of life.[6,7]
These findings are supported in the Cochrane review on cognitive stimulation that was carried out in 2012.[1]
What people say about Cognitive Stimulation Therapy?
Difference it made
People with dementia said that they were concentrating more and noticed an improvement in their memory. They also felt that the action of talking in the group helped them to remember:
"It always makes a change when you have to concentrate on something it’s more helpful for your memory . . . . I think it makes you concentrate more in everything you’re doing really". (p.947)
A third of carers said that their relatives were showing improvements in memory and that they were more willing to join in conversations outside of the group. Staff running the groups said that there was an improvement in the memories of people taking part and on the activities of previous sessions.
The project concluded that making evidence-based interventions more widely available is crucial for improving the quality of life for people with dementia and their families, while ensuring resources are used efficiently.
A training manual and DVD[3] has been developed with guidance on how to plan and run the sessions and different ways to check progress. This has been translated and adapted for other countries.[4]
Read more on how Blossom benefits Stroke Rehabilitation and Dementia Care:
References
Woods B, Aguirre E, Spector AE, Orrell M (2012) Cochrane Review: Can cognitive stimulation benefit people with dementia http://www.cochrane.org/CD005562/DEMENTIA_can-cognitive-stimulation-benefit-people-with-dementia
Spector A, Thorgrimsen L, Woods R, Royan L, Davies S, Butterworth M and Orrell M. (2003) Efficacy of an evidence-based cognitive stimulation therapy programme for people with dementia. British Journal of Psychiatry 183, 248-254.
Spector A, Thorgrimsen L, Woods RT, Orrell M. Making a Difference: An Evidence-Based Group Programme to Offer Cognitive Stimulation Therapy (CST) to People With Dementia. London: Hawker Publications; 2006.
Aguirre E, Spector A and Orrell M (2014) Guidelines for adapting cognitive stimulation therapy to other cultures. Clinical Interventions in Aging 2014:9; 1003–1007.
Aguirre, E., Z. Hoare, A. Streater, A. Spector, B. Woods, J. Hoe and M. Orrell (2013). “Cognitive stimulation therapy (CST) for people with dementia--who benefits most?” International Journal Of Geriatric Psychiatry 28(3): 284-290.
Miranda-Castillo, C., F. M. Tapia, A. R. Herrera, F. M. Ghigliotto and L. S. Guerra (2013). “Implementación de un programa de estimulación cognitiva en personas con demencia tipo Alzheimer: un estudio piloto en chilenos de la tercera edad. = Implementation of a cognitive stimulation program for people with Alzheimer disease: A pilot study in a Chilean elderly sample.” Universitas Psychologica 12(2): 445-455.
Yamanaka, K., Y. Kawano, D. Noguchi, S. Nakaaki, N. Watanabe, T. Amano and A. Spector (2013). “Effects of cognitive stimulation therapy Japanese version (CST-J) for people with dementia: a single-blind, controlled clinical trial.” Aging & Mental Health 17(5): 579-586.
Knapp M, Thorgrimsen L, Patel A, Spector A, Hallam A, Woods B and Orrell M (2006) Cognitive stimulation therapy for people with dementia: cots-effectiveness analysis. British Journal of Psychiatry 188: 574-580.
National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (2006). Dementia: supporting people with dementia and their carers in health and social care. Clinical Guideline 42. NICE/SCIE, London
Hodge S and Hailey E (2015) Memory Services National Accreditation Programme Third Annual Report 2013-2014.
Streater A and Orrell M (2015) CST in care homes: results of evaluation. Journal of Dementia Care 23(6): 12-14
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