With all the scientific evidence behind it, cognitive stimulation therapy is an obvious choice for people with dementia, says Balhousie Care Group’s Dementia Nurse Consultant Yvonne Manson. She explains how the trials have been going at some of the group’s care homes.

When our Cognitive Stimulation Therapy project reached the finals of the Scottish Social Services Awards this week, it was recognition that meant a lot. The programme faced stiff competition in the ‘Making Research Real’ category, and it was testament to the hard work the dementia team has done on CST.

The National Institute for Health and Clinical Excellence and the Social Care Institute for Excellence (NICE-SCIE) (2006) guidelines and the World Alzheimer report (2011) said of Cognitive Stimulation Therapy: ‘Cognitive stimulation has the strongest evidence by far for cognitive benefit for people with dementia.’

But what is different about it? Our training took two forms. First, training was delivered as classroom sessions, looking at the origins of CST and the available research as well as going over what exactly is involved in delivering CST. Once staff have undergone this training, there is experiential training. This is a training session run like a CST group where staff get to experience the program benefits for themselves. After training has been delivered, the support does not stop there. Our dementia services team continues to go out and support the facilitation of CST groups in each of the individual care homes. It is the experiential training and the support with facilitation that staff report is the most useful.

What difference has the program made? Here are a few stories from our residents and staff members:

Jim’s story

Jim had been in the care home for some months. He was a very private individual, and was experiencing some difficulty remembering faces and places. His routine became one of isolation where he would spend all day alone in the privacy of his own bedroom, only coming out for meals and then quickly returning to his room afterwards. He found it difficult to initiate conversation with others and seemed to feel safe in his own room.

Jim was introduced to the CST groups and he was happy to attend. He was very quiet during his first experience and staff ensured they supported him to feel involved at a level he felt comfortable with. As time went on, staff noted his confidence growing and friendships began to be forged with other residents.

As well as seeing Jim’s confidence grow, staff began to notice Jim was remembering the names of other participants and was volunteering more information about his own life.

During one of the sessions, Jim shared with the group his past interests in singing and how he used to be in a choir. Jim now volunteers to sing a verse of the chosen group song to the rest of the group, looking for prompts and a nod of the head before he begins to sing. He does this with no encouragement required from staff. Jim is now relaxed in the CST group and is now also eager to take part in different activities. He always comments on how much he enjoys the groups and is always one of the first participants to arrive for the start of each session.

As well as engaging with CST and other activities, Jim now rarely spends time in his room other than to sleep and has built strong friendships from the group. Jim took on the role of being on the health and safety committee and encourages others now to actively participate in the daily running of the care home, all of this from encouragement and support to take part in regular CST groups.

Alice and John’s story

Alice said about cognitive stimulation therapy: “The groups have only just started but I already want to ensure that they don’t stop. I see a real benefit for John and I want that to continue. It is important that there are things available for people with dementia to maintain their skills. John found some of the discussions less stimulating but when the group moved onto the physical activity he engaged with the group. He spends long periods sleeping and tires easily so it was great to see him engaged.”

Staff comments on CST

Gillian Silcock – Ruthven Towers

“The sessions have made such a difference, improved moods and built friendships. We laugh a lot, sing and generally have a lot of fun and each person looks forward to the sessions including the staff. I would definitely recommend CST to all care homes.”

Kerri Mclean – Clement Park

“I don’t know who enjoys it more, the staff or the residents. The groups are always happy we hold them in the ‘Clubbie’ which residents enjoy, and although the groups have not long started we are already seeing the benefits.”

Shirley Preston and Amber Mowatt – Monkbarns

“The residents have all vocalised how they look forward to the sessions and how they can’t wait to get involved and choose what is happening at the next session.”

Debbie Thomson – The Glens

“I truly recommend the positive outcomes of CST, and the outcomes for the residents who are on a dementia journey. It enhances quality of life, participation, inclusion, orientation and most of all produces smiles and fun. I was sceptical at first of what the benefits would be but it has been truly amazing and we have never looked back.”

Gail Dove – Luncarty

“Being involved in CST has opened my eyes to the benefits of how CST works for people with dementia. I find the local newspaper part most rewarding as people share stories – like ‘I knew that man, he lived next to my father’, or ‘That family was always bad news’.  There are lots of laughs as people speak so honestly. The sessions can get competitive too. We discussed numbers last week and ended the session with a few lively games of dominoes.”

Cheryl Banks – Dementia Services Facilitator

‘Supporting staff to facilitate CST groups has been a very positive experience for me. It goes without saying that the outcomes for our residents are immense, however to also see our staff having fun alongside residents and see them really enjoy what they are doing is just wonderful. Staff who facilitate the CST groups can sometimes be pushed out of their comfort zone, so to see these individuals flourish and develop both professionally and personally is just another welcome legacy to this fantastic therapy that is now being used consistently across our care homes.”

Emma Roberts – Dementia Nurse facilitator

“I have thoroughly enjoyed supporting in the roll-out of CST across the homes. It has been a very rewarding project and CST sessions are something I look forward to each week. I have loved developing good therapeutic relationships with residents across the group and watching relationships form between residents, as well as recognising improvements in cognition.”

Yvonne Manson – Dementia Nurse Consultant

“The program outcomes have been fantastic. Being a finalist in this year’s Scottish Social Services awards is just the cherry on top and is testament to the hard work of the teams across the organisation.”


The dementia team from Balhousie Care Group. From left to right: Cheryl Banks, Yvonne Manson, Emma Roberts.