3.4 CST Sessions

Aim

This topic aims to provide an outline of the group/individual CST sessions.

Learning outcomes

After completing the module, you will:

• Become familiar with the 14 CST individual and group sessions,
• Be able to develop a plan for running CST groups or iCST.

Introduction

CST sessions aim to build confidence, improve mental abilities and socialization, enhance learning, thinking, memory skills and promote problem-solving of persons living with mild to moderate dementia. They are designed to be relaxed, fun and to create opportunities for people to learn, express their views and work with others in a sociable setting.

3.4.1 How group CST sessions work?

Cognitive Stimulation Therapy includes 14 sessions of structured 45-minute (minimum) group therapy sessions (5-8 people in the group) and is run by two facilitators. The sessions run twice a week over seven weeks and each one covers a different topic. They aim to actively stimulate and engage people with dementia while providing an optimal learning environment and the social benefits of a group.

To make sure that there is continuity between the sessions they include some activities which are the same, such as the warm-up activity, a song, and a ‘reality orientation board’ which has information on the group, details including date, time, place, weather etc. Members give their group a name and sessions cover a range of activities to stimulate thinking, memory and to connect with others such as by:

• discussing current news stories,
• listening to music or singing,
• playing word games and
• doing a practical activity such as baking which involves measuring ingredients and following a recipe ^[1,2].

More specifically, Table 2 shows the structure of CST sessions.

Table 2: Structure of CST Sessions ^[1,2]

Each session is given a theme, with a choice of activities within each to be adapted for the interests and abilities of the group. Figure 3 provides a summary of the group CST sessions ^[3].

Figure 3: CST Sessions ^[3]

Notably, the proper CST team promotes the gender mix, addresses members at similar stages of dementia, and caters to the interests and abilities of the group.

3.4.2 How individual CST sessions work?

Individual CST intervention consists of structured activity sessions with a variety of themes including life stories, word games, quizzes, art, reminiscence, discussion of current affairs, and being creative. Each iCST session lasts around 20 to 30 minutes and each CST and Maintenance CST session (we will discuss it in a following topic) was split to create two iCST sessions, which resulted in a 75-session program lasting over 25 weeks. Figure 4 shows the structure of iCST sessions, which have a lot of in common with the structure of group CST. However, a few adjustments had to be made to make it suitable for use at home. Instead of the introduction and closing element of group CST, iCST sessions begin with a discussion of orientation information (5 mins) and current affairs (5 mins) followed by a themed activity (20 mins) ^[4].

Figure 4: Structure of iCST Sessions ^[4]

Figure 5 gives an overview of the iCST session themes. Some themes occur more than once. The iCST omits the key principles geared toward the group process; rather, it stimulates discussion between the person with dementia and the carer and encourages them to enjoy the time they spend together ^[4].

Figure 5: iCST Sessions ^[4]

3.4.3 Inclusion criteria to CST sessions

Before the beginning of the team or individual sessions, it is significant for the facilitator to take into consideration the following steps:

• Assessment of individuals – strengths, sensitive issues, interests, literacy, etc. (eg. Does the person have a severe hearing/visual impairment (even with an aid/glasses)? Is the person too agitated to stay for the short session? Does the person have severe health problems that will affect their ability to attend the session?)
• Explaining the nature and purpose of CST sessions
• Discussing continued consent – that people can withdraw at any time with no negative consequences
• Organizing transport, a room, staff
• Preparing folders for members.

Synopsis

Key points:

• CST involves 14 themed sessions, normally twice a week for seven weeks, lasting 1 hour each.
• iCST intervention consists of 75 structured activity sessions with a variety of themes
• Each CST/iCST session is structured but there is a choice of activities to tailor to the interests and abilities of the group/individual.