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CRT is not a single therapy, but a collection of individual treatment strategies designed to improve problems with memory, attention, perception, learning, planning and judgment brought about by brain injury, neurological disorders or other illnesses.
When people talk about Cognitive Rehabilitation Therapy (CRT), they’re actually not talking about one therapy - they’re talking about a constellation of techniques that are used to try to improve an individual’s ability to function after injury. In other words, CRT is not a single therapy, but a collection of individual treatment strategies designed to improve problems with memory, attention, perception, learning, planning and judgment brought about by brain injury, neurological disorders or other illnesses.
Examples of cognitive rehabilitation therapies include writing tasks and interaction with computer-assisted programs. The goal of many of these therapies is to improve functions of memory, attention processing, social communications, problem-solving and the regulation of emotions.
So far, evidence supporting cognitive rehabilitation is encouraging, and efforts by the Department of Defense continue to study and test the effectiveness of several forms of CRT.
It should be noted that in cases of mild traumatic brain injury (mTBI), nearly 90 percent of patients recover with no residual problems and only those with persistent symptoms need to be evaluated and treated. Diagnostic tools for mTBI are not precise and neuropsychological assessments can be difficult to interpret. Therefore, medical evidence for effectiveness of cognitive rehabilitation therapies has been difficult to measure.
To understand the role CRT may play in treatment plans for people with a variety of traumatic brain injuries (TBI), it’s important to see what might happen when different parts of the brain are impacted.
Click on the brain for an interactive overview about various kinds of brain injuries.
Does DoD/TRICARE cover CRT?
On April 14th, 2010, the Assistant Secretary of Defense (Health Affairs) directed the implementation of a broad based DoD pilot program intended to conform to the proceedings, and resulting guidance document, of the Consensus Conference on Cognitive Rehabilitation for Mild Traumatic Brain Injury held in April 2009. This guidance document outlined a standardized and measureable process for the provision of CRT services. This policy mandated the implementation of the guidance at 13 military treatment facilities (MTF’s).
In 2010, DoD provided over 45,000 hours of care involving CRT to service members and over 32,000 hours to family members of active duty members and retirees. These treatments were delivered by a wide array of health professionals, including psychologists; occupational, speech and physical therapists; and physicians.
For more information, please see the TRICARE CRT Fact Sheet.