Cognitive Stimulation Therapy (CST) is a group treatment for people with mild to moderate dementia.
CST was developed at University College London in 2001 by Professor Aimee Spector. It was designed as an intervention to improve cognitive function for people with mild to moderate dementia.
Early research studies evaluating the effectiveness of CST compared its impact with outcomes resulting from drug treatments. The evidence indicated that CST was as effective as acetyl-cholinesterase inhibitors in the cohorts of subjects that were studied.
CST was subsequently included in the UK Government’s NICE guidance on the management of dementia as a recommended non-pharmacological treatment. Referral to a CST programme following dementia diagnosis is strongly advised irrespective of whether (or not) the person is also receiving drug therapy. The two approaches are complementary.
Group CST programmes involve 14 or more sessions of themed activities, which typically run twice weekly. Sessions aim to actively stimulate and engage people with dementia, whilst also providing an optimal learning environment and the social benefits of a group. Many memory services offer CST programmes to people with dementia immediately following diagnosis.
There are 18 guiding principles embedded into CST interventions:
- Mental stimulation
- New ideas, thoughts and associations
- Using orientation, both sensitively and implicitly
- Opinions rather than facts
- Using reminiscence as an aid to the here-and-now
- Providing triggers to aid recall
- Continuity and consistency between sessions
- Implicit (rather than explicit) learning
- Stimulating language
- Stimulating executive functioning
- Maximising potential
- Building / strengthening relationships
Longer-term ‘Maintenance CST’ is provided for people who have completed a basic programme. The maintenance approach is flexible, aiming to maximise cognitive function for the person for as long as possible. Maintenance CST is often offered in community settings by health and social care organisations.
One-to-one CST, known as ‘Individualised CST’ or iCST follows the same themes and principles and can be offered in people’s own homes.
CST programmes can be delivered by a range of health and care professionals, including Psychologists, Occupational Therapists, Nurses, Support Workers, Dementia Advisers.
There are three manuals that explain how CST is delivered and provide resource material and session plans: ‘Making a Difference 1’ – a basic guide to the 14 CST themed sessions, ‘Making a Difference 2’ – which includes a training DVD, and ‘Making a Difference 3’ – a manual for individualised CST. These manuals are available from Hawker Publications: http://www.careinfo.org/books and on Amazon.
Training courses in CST are also available at UCL and through delivery partners, Dementia Pathfinders: http://dementiapathfinders.org/cognitive-stimulation-therapy.html
For more information about CST, visit: http://www.cstdementia.com/