Tailoring Cognitive Remediation
by Ariane Giguère-Rancourt, Neuropsychologist
I’m a neuropsychologist who graduated in 2021 in Quebec, Canada. I defended my thesis on cognitive training for persons with Parkinson Disease and cognitive impairment, but now I work in a child psychiatry clinic (long story short). During my studies, I explored many different pathologies and I totally loved working with young clients who had mental health issues. Many of those clients deserved to have their chance in life and I felt we could give them hope for the future. Unfortunately, cognitive deficits were sometimes big obstacles for them, and I did not know what we could do to help them reach their full potential.
In Quebec, the role of neuropsychologists often consists of assessment only, without intervention. I want that to change. In a wonderful course we had at U Laval about the importance of our work for the patients we work with, I realized that I was not alone to have interest in neuropsychological interventions. For my doctoral research, I was formed to Goal Management Training. I realized that cognitive intervention is not a ‘one size fits all’ process, so it is important to offer different tools to each person. CIRCuiTS is very interesting for tailoring cognitive intervention to patients 'deficits' because it offers a wide range of different tasks.
Thinking about it, I cannot say that I have a favourite task in CIRCuiTS, but I prefer the moment when we finish a task, and we can generalize the task to the daily activities of the patient. I really feel that I’m helping the patient at that moment. I also really like when we review the homework the patient did during the week, how they used the strategies we learned together. These moments are the biggest success for me.
Of course, there are challenges also, especially with patients that have complex issues and that would need other intervention (for example, I once felt helpless with a patient that had addiction issues, with financial problems, which is more frequent than we think). In those moments, I believe humbly that a key skill for delivering CIRCuiTS is compassion. Patients feel and know when you have their best interest at heart, they feel the compassion you have for them, even when you are quite different persons. Concerning that, a very interesting book (one of the books that helped me find a sense to my work) was written in French by Luc Vigneault, « Je suis une personne, pas une maladie! » The title could be translated to ‘I am a person, not a disease!’
My deepest wish for all my patients is that they learn to know themselves better, in their whole being: their strengths, weaknesses, their values, and I truly wish that this knowledge helps them to love themselves and dream about the future. Neuropsychological assessment and intervention are only a means to achieve that, but it is the little part I can do to help.
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