Tips for Using Spaced Retrieval Therapy
Spaced retrieval therapy (SRT) is one of my favorite ways to improve memory of functional information, but it is unexpectedly difficult. This post is inspired by the questions and comments I have received in hopes of making using SRT easier for you.
Tasks to use between intervals
I have used a variety of tasks between SRT intervals and have found some things work better than others. I try to find tasks that can be easily stopped and started (e.g. not a television show or BINGO). I have successfully used the following tasks:
- Browsing newspapers (visual scanning) with a patient who has a lifelong hobby of reading the newspaper
- Talking about family photos to target long term memory and reminiscence therapy goals
- Sorting items or tidying up room or bedside table which may target visual scanning, problem solving, and attention
- And sometimes we just chat. It may not be the most skilled task for between intervals, but it helps build rapport. When working with short intervals, we are working with greater memory deficits. Finding a one-minute activity can be challenging.
I usually keep the same task for between intervals throughout the SRT session, so I am guiding the patient between two tasks (memory target and interval task).
Keeping things entertaining
If you are doing spaced retrieval therapy correctly, you might be getting a little (or a lot) bored. I read a comment from an SLP on a forum stating she was using SRT, but she felt she should be mixing things up a bit, so she wasn't doing the same thing. Do not let your feeling of boredom result in attempts to vary the task, switch to a different stimulus, or otherwise mix it up. The success of SRT relies on the repetitive nature at increasing intervals.
As therapists, we strive to build good relationships with our patients. And as SLPs we know a thing or two about pragmatics and social norms. It is not polite to ask the same question or tell the same story over and over. So if you are anything like me, when you do SRT there are days you get on your own nerves. It is okay and completely normal.
Stick to SRT protocol to increase patient progress. If you are not seeing any progress in length of intervals, your patient may not be appropriate for SRT.
To ensure I can present stimuli with the same gusto and enthusiasm that my client deserves, I may break up treatment time over the course of the day. So if I plan to see a patient for 30 minutes during the day, I may see them for three 10-minute sessions or two 15-minute sessions.
I often pop into an SRT patient's room to see if we can do a quick session. Depending on what I am trying to target, I have done a quick SRT session in the dining room, waiting for the hair salon, in the therapy gym, and in patients' rooms. If I am training a location-dependent task (e.g. using call light/button), I make sure we complete the session in the location where the task would be completed.
Hopefully these tips will inspire you to try spaced retrieval therapy with a client. It can be very successful in for training functional targets.
To learn more about how spaced retrieval therapy works, please check out my blog, Gray Matter Therapy.
Rachel Wynn, MS, CCC-SLP, is a speech-language pathologist specializing in elder care. As the owner of Gray Matter Therapy, she provides education to therapists, healthcare professionals, and families regarding dementia and elder care. She is an advocate for ethical elder care and improving workplace environments, including clinical autonomy for therapists. She has an upcoming webinar "Dementia Communication Strategies to Improve Therapy Outcomes."