Thinking Well was created to address the long-term cognitive impairment that interferes with the daily lives of people with serious mental illness. Dr. Philip D. Harvey of the University of Miami Miller School of Medicine has likened this impairment to a bad guest: “It shows up early… and it sticks around over the lifespan.” Many of the adverse outcomes associated with schizophrenia – social isolation, homelessness, and the inability to hold a job – can be traced to cognitive impairment that continues, even after symptoms have been treated and controlled.
The Thinking Well program blends two basic techniques to address cognitive impairment: cognitive remediation and compensatory cognitive training.
Cognitive Remediation – uses individualized drills and group bridging sessions to improve functioning in targeted areas of cognition, such as attention, memory, and problem-solving. Assessments are used before the program to determine which areas require focus and again at the conclusion of the program to show specific improvement.
Compensatory Cognitive Training – focuses on teaching people real-world cognitive skills and strategies and helping those strategies become habits.
Together, these two techniques form the foundation of Laurel House’s recovery-oriented approach to a very practical rehabilitation.
Goals of Thinking Well
- Create a supportive environment for people to learn and to enjoy their lives
- Stimulate learning, or relearning, of cognitive tasks, and by extension, living skills
- Develop skills in specific areas of attention, processing speed, working memory, visual learning, verbal learning, and problem-solving and reasoning to improve daily functioning
- Prepare people for the challenges of the workplace, school, and independent living
- Result in statistical improvement in specific areas of thinking, as well as improved functional outcomes (i.e., getting a job, attending and succeeding in post-secondary education, living independently)
Central to the Thinking Well program are instructor–led computer exercises and bridging groups. Based on the Neuropsychological and Educational Approach to Cognitive Remediation (NEAR), assessments are used before the program to determine which areas require focus and at the conclusion of the program to show specific improvement. This activity allows people to practice and improve their thinking skills, and discuss with peers how these skills apply to real-life situations at home, school, and in the workplace.
Thinking Well focuses on the following areas of thought or cognition:
- processing speed
- working memory
- visual learning
- verbal learning
- problem solving and reasoning
How to Access Thinking Well
Laurel House currently offers daily sessions in cognitive remediation, consisting of instructor-led computer-based games and exercises, followed by group discussion. Sessions are led by skilled clinicians trained by Dr. Alice Medalia, founder of the NEAR model of cognitive remediation and director of the Lieber Clinic in Manhattan.
Laurel House strives to integrate the principles and techniques of cognitive rehabilitation in its recovery-oriented employment, education, and residential programs. This integration of cognitive services in these environments is referred to under the respective names of Thinking Well at Work, Thinking Well at School, Thinking Well at Home, and Thinking Well in the Community.
To find out more about the Thinking Well program at Laurel House or to enroll in services, contact:
Denise Vestuti, LCSW
Jennifer Sagastume, LMSW
Thanking Well Coordinator
For more information about Thinking Well, view the Thinking Well Fact Sheet.