Having trouble remembering to feed the dog, recall where you left your appointment book, or conjure up the name of the fourth Beatle on trivia night? And what about your clients? Are they suffering from cognitive impairment or decline? The solution may lie with a concept that’s garnered increased attention—and skepticism—in recent years: computerized brain games.
The idea that these games could play a role in preserving and enhancing cognitive function is being backed by advances in the study of neuroplasticity, overturning the notion that human brainpower is set on an inevitable, irreversible course of progressive decline. Indeed, many studies show that computerized brain training designed to sharpen the mind can yield benefits that range from strengthening memory to boosting intelligence and reasoning skills. But, of course, the rapid ascension of these games—made possible by the ubiquity of portable electronic devices such as mobile phones—has also raised questions about how fully they live up to their claims.
Enter Dan Hurley, a science journalist and author of the recently published book Smarter: The New Science of Building Brain Power. After interviewing several hundred researchers and study participants and reviewing countless peer-reviewed trials published on the subject, Hurley reached a conclusion: “It is absolutely possible to move the needle on improving various kinds of cognitive abilities,” he says. Although four of the studies he reviewed revealed no cognitive improvement stemming from brain games, 75 of them pointed to numerous beneficial results, suggesting that brain training can improve “real-world abilities of children with attention deficit hyperactivity disorder, older adults with mild cognitive impairment, people recovering from chemotherapy or radiation for cancer, people with Down syndrome, victims of traumatic brain injury, and otherwise healthy adults and children.”
Hurley says that even the field’s most skeptical researchers now agree that working memory and attention can be strengthened. And those benefits extend far beyond helping high-functioning people remember where they put their keys. Hurley adds that disorders such as depression and schizophrenia are often accompanied by seriously diminished working memory. “In fact,” he says, “one of the strongest predictors of long-term outcomes for people with major depression and schizophrenia is their level of working memory—after all, someone who cannot ‘think straight’ and make sense of life’s daily challenges is going to have a very hard time handling daily activities.”
But for all the touted successes of computerized brain games, most of those with credible backing aren’t commercially available. Some reputable programs, like the Cogmed Working Memory Training program created by neuroscientist Torkel Klingberg, are only available in schools and healthcare settings. Programs like Klingberg’s are also run by professional coaches, meaning that popular memory games on mobile apps or the Internet might only go so far.
In the search for a universally accessible method of improving cognitive abilities for people of all ages, one option stands above the rest: physical exercise. Considerable research supports the relationship between exercise and improved cognitive function. There are also parallels in the processes of bolstering mental and physical fitness. Not unlike building muscle by gradually increasing the weight on a barbell, improving mental fitness relies on progressive training in making exercises increasingly difficult. “The consistent link between all methods showing benefits is that the training must be progressive,” says Hurley. “It must get harder as you get better.”
Games like chess or bridge, which rely heavily on working memory and become progressively harder, are just a few avenues for improving cognitive function. There’s also a great deal of evidence supporting the cognitive benefits of learning to play a musical instrument or performing mindfulness meditation, says Hurley. And unlike online brain games, these exercises stand the test of time. In fact, a study published in the January 2014 issue of Brain Structure & Function showed that as musical expertise increased, so did the density of gray matter in areas of the brain involved in higher-order cognitive processing. Also, a Harvard study published in 2011 showed that mindfulness meditation increased gray matter in parts of the brain that govern learning, memory processes, and emotion regulation.
The takeaway from these findings supporting brain games? Computerized brain training is yet another tool in your arsenal to boost memory, intelligence, and reasoning skills. At the very least, maybe a couple of brain games means the difference between remembering to pick up milk at the store and having dry cereal the next morning.
— Tori Rodriguez
Grim Job Prospects for Mental Health Grads
For graduate education in the field of mental health, 2013 was a booming year. Approximately 39,500 students were enrolled in the 639 accredited graduate programs in counseling, and doctoral programs in clinical psychology reviewed a staggering 44,753 applications from prospective students, which was a 24 percent increase from 2009. But where exactly did the 10,260 degree earners from mental health counseling programs in 2013 land after the pomp and circumstance of graduation? And why do students continue to pour into graduate programs when they often face grim employment prospects or incredibly low-paying work in the nonprofit sector upon graduation?
In part, prospective students may be lured by the 29 percent job growth projected by the Department of Labor for mental health counselors and marriage and family therapists by 2022. But this optimistic number alone can’t explain the growth spurts in academic programs. Lynn Grodzki, a psychotherapist and master certified coach for mental health professionals, sees the lure of the helper role as a primary draw for young people and for older adults seeking a second or third career. “I think that these types of careers have a lot of meaning and purpose,” says Grodzki, “and what I can say is that sometimes younger people aren’t clear about what’s going to be the outcome for them once they graduate.”
Additionally, programs in counseling and marriage and family therapy lack the typical prerequisite academic requirements of other graduate programs, a draw for many who hold an undergraduate degree that didn’t lead to a clear career path. Prospective students can apply for in-person or online programs at multiple points in the academic year, making the process quick and painless. With graduate programs focusing on clinical guidance rather than career-planning advice, however, the mass of students are left wondering whether their postgraduation expectations will be realized when they enter the field.
“Nobody’s being honest with them about what to expect,” says Casey Truffo, a marriage and family therapist and founder of the Therapist Leadership Institute. “All graduate schools care about is producing clinicians who know how to treat people safely and getting them a job at a nonprofit or other low-paying agency. I think many of the graduate schools are keeping us as one of the lowest-paid healthcare professionals because they don’t teach how to make a living doing it.”
Truffo and other consultants insist that students exiting master’s programs who lack entrepreneurial skills will have to adjust their initial expectations about success in the job market, particularly when it comes to private practice. “Marriage and family therapy and counseling programs seem to be producing quite a few people who have a dream of private practice,” says Joe Bavonese, codirector of Uncommon Practices Consulting. “Given the number of clients out there who want and need therapy, I don’t know how realistic that is.”
Of course, being taught business skills would certainly prove handy to help graduates tackle the amount of debt they accumulate in their schooling. Walden University, an online institution offering a master’s of science in mental health counseling, disclosed that the average student graduating from the program in 2012 owed $79,710 in student loans.
Leaders in the field also worry that even students who opt out of the private-practice track may not be adequately trained to meet the needs of the changing healthcare marketplace. “The PhD programs in psychology now are 20 years behind what the marketplace needs,” says Nick Cummings, former president of the American Psychological Association. “And most counselors and social workers have only an outside knowledge and interest in what the healthcare system is about, and they don’t know how to talk to physicians. Programs don’t level with the students about job prospects when they graduate, and I think that does students a disservice.”
In addition to job prospects, students shopping for graduate programs must also weigh the costs and benefits of choosing one degree program over another, as well whether to continue onto doctoral level programs in psychology or counseling. Wynn Mallicoat, a 2013 graduate in counselor education and supervision at the University of South Carolina, managed to find her niche through teaching part time and managing her own supervision practice for beginning counselors. Mallicoat, however, advises against pursuing the doctoral route for those students interested in private practice.
“I’d probably encourage them to pursue a doctorate in a different area than counselor education,” she admits. “With other degrees, you’d actually see a difference in your pay with the doctoral degree.”
Truffo agrees, adding that having a doctoral degree doesn’t matter much when it comes to private practice, nor does the difference between being a licensed counselor, social worker, and marriage and family therapist. “Unless you live in a town like Stanford, California, where everybody in town has a PhD, then people really don’t understand or care what credentials hang on your wall.”
Bavonese also attributes success to business savvy more than degree level. “You have to devote as much time to business training as you do your clinical training, and that’s a bizarre concept to some people because they think that being talented clinically is enough. Today’s competitive marketplace is dominated by the Internet and short attention spans. If you don’t stay up to speed with online marketing knowledge, it’s going to be very hard to succeed.”
Most educators advise that it’s too soon to tell how the flood of graduates will mesh with the anticipated demand in the private-practice sector and healthcare marketplace. Truffo, however, predicts a changing of the tide in the coming years. “There’s an interesting shift in the zeitgeist right now—young people are leaving undergraduate programs and aren’t ashamed of wanting to make a lot of money. This will pose a real challenge to graduate schools in the future if they want to continue to turn out therapists, because they’ll have to show them that a mental health degree is worth the investment of time and money.”
— Kathleen Smith
Illustration by Ralph Butler
Kathleen Smith, PsyD, PLLC, focuses her practice on treating a number of clinical issues including: anxiety disorders (generalized anxiety, social anxiety, obsessive-compulsive disorder, and specific phobias), depression, ADHD, and traumatic events, including abuse and domestic violence.
Tori Rodriguez, MA, LPC, is an Ayurvedic psychotherapist and health coach in Georgia.