Cognitive Stimulation Therapy

Cognitive Stimulation Therapy (CST) is a non-medical intervention therapy that is used for people with mild to moderate dementia. It is a short programme of actions (7 weeks) that helps provide mental stimulation through meaningful activities, which in turn helps to preserve cognitive health, give a better sense of wellbeing and is recommended by National Institute for Health and Care Excellence (NICE).

For over 20 years, CST has been widely recognised as a beneficial treatment around the world. Before this time, there was little in the way of intervention for dementia and people were just left to decline. There had been some small investigations into psychological research using patients with dementia but these had not proved successful.

With little in the way of drugs being successfully developed to help, a group of UK scientists felt there was a need to explore the effects of psychotherapeutic treatment and they set up their own trials, using a mixture of previous experimental methods and other multisensory stimulation therapies on a small group of people with dementia. These trials proved to show some positive results on cognitive functioning and thus the trials were extended to a wider number of people who also showed clear signs of improvement in their cognitive abilities, physical fitness, communication as well as having renewed confidence and lower anxiety levels.

iCST – Individual Cognitive Stimulation Therapy

iCST works in a similar way to CST but instead is aimed at those who find it difficult to be in a group setting. The sessions are shorter but continue for a longer period of time (around 25 weeks).

mCST – Maintenance Cognitive Stimulation Therapy

mCST again works in a similar way to CST and iCST, but continues after the initial 7 weeks programme with an additional 24 weekly maintenance sessions.

Who is CST for?

These therapies are good for anyone diagnosed with mild to moderate dementia. They are aimed at providing support to people who may find their memory, communication and physical skills are affected by the disease. The activities are designed to help keep the brain working to its optimum level (each person will have different abilities) and to maintain physical and mental health. It can help to improve relationships and build confidence too.

Do you need to be qualified to perform CST?

CST and mCST are recommended to be delivered by trained healthcare professionals or care assistants but iCST can be done by trusted family members, friends or a support worker who follow the key principles of the course to have benefit.

What does a typical CST session look like?

Sessions are 45 minute, twice-weekly sessions for a period of 7 weeks. Each session covers a different theme but there is a structure to each session that will begin with a 10-minute warm-up activity that will likely take the form of singing a ‘theme’ song, followed by that day’s activity which will incorporate memory, thinking and socially connecting. The main activity will likely follow the following configuration:

Physical games
Sound
Childhood
Food
Current affairs
Faces / scenes
Word association
Being creative
Categorising objects
Orientation
Using money
Number games
Word games
Team quiz

The emphasis is on having fun while being actively involved. There will always be a Reality Orientation board that shows the day, date, time, weather etc. At the end of the session, there will be a 10 minute summary for feedback.

iCST sessions are shorter – around 20-30 minutes duration without the starter activity. These are still themed but maybe a quiz, listening to sounds, reminiscence etc. The emphasis is still on a relaxed, enjoyable experience for all involved.

What kinds of products are used in a CST session?

A number of products can be used effectively for these sessions and many can be easily bought or even found around the home.

Physical games – a lightweight inflatable ball can be thrown to each other or bounced along the floor. Badminton kits or balloon swatter games are ideal for either seated or standing play.
Sound – musical instruments come in all shapes and sizes – why not use bongo drums to help develop rhythm or bang a tambourine or shake maracas to a musical CD.
Childhood – dolls, toy cars and building bricks can be used to have a discussion and reminisce about each person’s experiences.
Food – if premises allow, baking easy cakes or decorating biscuits can be great. Ready to go kits can be bought easily from supermarkets.
Current Affairs – news clips from YouTube can be ideal – it might take on the form of the Royal Family or an amusing story for discussion.
Faces/Scenes – famous faces or landmarks could be used for identifying – this could possibly become a matching game.
Word Association – a chalk board or write on-wipe off board is a great tool to write words on, or why not use a magnetic board and letters to add a fun element?
Being Creative – if setting up time is short, there are a good many ready-to-go craft kits available – with many ideal for anyone with limited ability. Specialist self-opening scissors are also available for weak grips.
Categorising Objects – games like PicLink are designed with this in mind, with a wide range of photographic cards that be used for grouping into similar, opposite, colour matching, vintage, modern etc.
Orientation – a treasure hunt can be set up with the minimum of equipment i.e. instruction sheets and the ‘treasure’ (could be a bar of chocolate or a card saying ‘Well Done’).
Using Money – a toy cash register could be used with an assortment of items to ‘buy’. Players have some loose change to spend and work out which coins they need to use. Or some simple adding/subtracting games using images of coins.
Number games – dice come in all shapes and sizes and are a fun way to use numbers. Or a game of safe darts using Velcro balls to throw are great too.
Word games – Match the Song Title game is a good way to incorporate reading, speech and memory too. Simple word searches and crossword puzzles are also great to use.
Team Quiz – we have many quiz games available, but for one with simple questions try the Quiz Floor Mat game that comes with beanbags and topics to answer.