I am nearing to the end of my whirlwind 6-week occupational therapy placement with Alzheimer Scotland and it’s been excellent, but a very quick experience. I’ve been told that the best placements always go the quickest.
My main task while on placement has been to offer two separate cognitive stimulation therapy groups for people with dementia at a day care centre. I’ve been very lucky as the brief was to start from scratch and hand over the group sessions to another member of staff when I left; I got to do all the fun stuff.
I love building projects from the ground up, you get to research, plan, assess everything, and create resources; it is a very satisfying process, though I will be happy not to see a paper trimmer and a laminator for a little while. I thought I would share a few thoughts and tips on my experience of setting up and running a cognitive stimulation therapy group.
The intervention can be delivered as a group therapy or individually and can involve games, singing, reminiscence, sharing stories, arts and crafts. The aim is to help strengthen communication, thinking and memory; and slow down cognitive decline (British Psychological Society, 2014).
Thought one – Your role in the group: The “Presilitator” (noun)
- the blending of the words ‘presenter’ and ‘facilitator’
- the art of juggling many balls at once
For those who are not familiar with the roles ‘presenter’ and ‘facilitator’ in context to running group sessions, I often think of the presenter as ‘standing up on stage’ for a performance and the facilitator as metaphorically ‘sitting with the audience’. I have almost 10 years’ experience in running groups and I still get stage fright every time I am about to go on; it can be nerve racking at times.
As the presenter you have the responsibility to put on a good show for your participants, while as facilitator it’s your job to make the performance easy and engaging.
Though the ‘presenter’ and ‘facilitator’ roles are skills in their own right, the real challenge is to seamlessly blend the two together. The action of figuratively jumping on and off stage between roles and reacting accordingly to the needs of people in your group, tweaking your material and your responses as you go.
By successfully blending these two roles in your cognitive stimulation therapy sessions, you will create an enabling environment, where each person’s needs are considered independently, for the positive interdependent life of the group.
- Consider blending and developing your inner ‘presenter’ and ‘facilitator’, the two roles work hand in hand.
- Uncomfortable silence is usually an indication to react, speak and move on. Personally, I measure uncomfortable silence as around 5 seconds of absent dialogue within conversation. If you consider a person with dementia can take longer to process information, 5 seconds is not as long as you think and while you may find long pauses uncomfortable, it does not mean they do; give people time to respond before moving on, it’s not a race to get through your session material.
3. Remember to gain verbal member consent before every session, this might be a short conversation about what you are planning to do and asking if they want to attend. If no consent is obtained, you may fall into a trap of subjecting members to a process of ‘doing to’, rather than ‘involving in’.
Thought two – Love your laminator
According to the Cognitive Stimulation Therapy book ‘Making a difference’ by Spector et al (2006), each of the 14 sessions start with introducing each member, orientation to date, time, location and a discussion of a current news article. Imagine you are starting a cognitive stimulation therapy group for the first time and you bring 6 copies of a daily newspaper and hand them out. You try to discuss an article on page 7, but many people are losing their place, reading through the paper or finding the print too small. You then start your main activity which is called ‘sound’ and you have chosen the suggested activity of playing sound effects and ask members to guess the sound. You are using a laptop with YouTube over wifi and your connection keeps going down and the samples are not quite right.
The lesson here is to allow time to prepare session resources and try them out; do not under estimate the length of time, you will need to do this. When I put a sound effect cd together, it took me around 6 hours to find 20 suitable audio samples on the internet. Then I used audio editing software called audacity to shorten all the samples to 20 seconds. I found 20 pictures on the internet which related to the sound effects and laminated them; I asked members to match sound to picture.
- Allow plenty of time to familiarise yourself with the manual and to find suitable resources. You can add to your resources over time.
- If you are considering running regular cognitive stimulation therapy groups or you’re a larger organisation with people resources, which may include students, then setting up a digital resource bank may be just what you need. This would be an excellent way of continuing to invest in materials for your groups.
- Allow yourself time to find suitable news articles and photocopy them, so that you hand out one page in a suitable print size, ideally A3.
Take the opportunity to embrace your group sessions, allow yourself to make mishaps and reflect on them. This will make the groups more enabling and will develop your inner ‘Presilitator‘ and most importantly build your resources; love your laminator!
Free resources to get you started:
BBC sound effects for non-commercial use, available at: http://bbcsfx.acropolis.org.uk/
BBC sound and video dementia resources, available at: https://remarc.bbcrewind.co.uk/
Audio editing software, available at: https://www.audacityteam.org/
How much things cost in the past, available at: https://www.hillarys.co.uk/back-in-my-day/
Lists of food words, available at: https://www.enchantedlearning.com/wordlist/food.shtml
Second year, MSc Occupational Therapy student at the University of Cumbria.