By Trish Bogucki
This is the second half of an interview I did with my cognitive therapist Olivia Bell on August 24, 2017; you can find the first half HERE. This part of the interview touches on neuropsychology, debunking some misunderstandings about cognitive therapy (CT), some advice Olivia had for NPH patients and spreading the word about CT.
Trish: I’ve read a little about neuropsychologists helping some NPH patients – how does your job differ from that of a neuropsychologist?
Olivia: While Neuropsychologists and Speech-Language Pathologists can both evaluate and treat cognitive deficits, Neuropsychologists are usually involved in more psychotherapy and deal with more emotionally based issues. They are also able to provide counseling that is not within the scope of practice of a Speech-Language Pathologists. The therapy that Speech-Language Pathologists provide is related to more functional communication/abilities as they relate to everyday life/functionality. Speech-Language Pathologist also evaluate and treat a wide variety of deficits such as language, voice, swallowing, speech, etc which are services that a Neuropsychologist does not provide.
Trish: I remember you asking me how my week had gone and after I told you about an upsetting incident where I took a wrong turn on my way to a place I used to know how to get to, we talked about my occasional “meltdowns” and strategies for avoiding them in the future. I found that part of our discussions extremely helpful since there is definitely a frustration factor to coping with the effects of NPH.
What are the most important things to know about CT?
Olivia: It is important to understand that every patient is different. What may be successful for one patient, may not have the same effect for the next. As stated above, it is important to at least complete an evaluation with a skilled therapist to assess whether or not cognitive therapy is warranted and if so, determine functional/realistic goals that are specific to the individual.
Trish: I remember you saying that I had both short-term memory problems and attention deficits. We worked on both areas with great long-term results.
Are there any common misunderstandings about CT?
Olivia: One of the biggest misunderstanding about cognitive therapy includes that it simply does not exist and that it isn’t successful/helpful. It is important to understand that just because your memory may not “get better”, one of our main goals in therapy is to provide strategies to enhance patient’s abilities and functionality in their everyday life. Speech-Language Pathologist work closely with patients and caregivers to specialize treatment for each individual. It is important for me as the professional to make therapy as functional as possible in order for carry-over to occur and for patients/caregivers to get the best results out of therapy.
Trish: I remember you saying in our first appointment that you may not be able to cure my memory loss but you could definitely give me strategies for dealing with it. Before NPH I had a terrific memory so it was aggravating not to be able to rely on it and to commit to using your strategies. But once I saw that they worked I was sold (and I got hooked on the online brain games!).
Trish: What parts of your job do you enjoy the most?
Olivia: One of my favorite parts of my job is being able to build rapport with my patients. I enjoy working with them week after week and hearing about their triumphs but I also like the challenge of having to make changes when certain strategies may not be working as planned. I love that I can work with patients and yet months after discharge we are still in touch and able to meet up for dinner, as we are doing tonight. I find it most rewarding to work with adults because they are motivated to regain skills or functions that they have lost. There is nothing better than the emails or “drop by” visits from former patients who are getting in touch with you to share their success stories!
Trish: I have enjoyed staying in touch and letting you know how I have progressed. You have been very encouraging, so it pretty exciting to be collaborating with you on this blog post!
What is your best advice for NPH patients?
Olivia: Advocate for yourself and for your loved ones and seek out help if you are noticing changes in functioning. As already mentioned, cognitive therapy is not as well known as other therapies that are out there. However, it does exist! There are Speech-Language Pathologists out there that are willing to work with patients and caregivers in order to help patients return as close to baseline functioning as possible.
Trish: I couldn’t agree more and just wish I had asked my doctor sooner what could be done about my memory issues.
Olivia: I would also suggest continuing to educate others and continuing to get the word out about cognitive therapy. Sometimes patients are embarrassed by their deficits. By continuing to provide education about cognitive therapy, we can help individuals realize that they are not alone and help to initiate the therapy process as soon as possible.
Trish: I hope that this post helps inform NPH patients and their caregivers about cognitive therapy and the benefits it offers.
Post Script: I want to thank Olivia very much for the time she spent answering my questions. I certainly benefited greatly from the time I spent seeing Olivia professionally, so I want to spread the word about cognitive therapy! I would also like to thank The Valley Hospital for allowing me to publish this interview on the Hydrocephalus Association website. The Valley Hospital is where I had my shunt surgery and a few other procedures over the past two years, so I’d also like to thank them for the excellent and compassionate care I received every time.