Although clinical neuropsychological research tends to focus on assessment and differential diagnosis, a growing contingent of neuropsychologists are attempting to apply their knowledge of neurobiology and cognitive and emotional functioning to pursue interventional neuropsychology. To this end, we speak with Glenn Smith, Ph.D., ABPP-CN, about the cognitive remediation program he has developed to address cognitive and emotional changes associated with mild cognitive impairment (MCI) and dementia, the Healthy Action to Benefit Independence of Thinking (HABIT) program. Dr. Smith discusses his view of clinical and research efforts to address MCI, as well as his experience in psychology leadership and supervision of both postdoctoral and predoctoral practicum students.
A pdf of the transcript for this episode is available here.
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Topics covered (with time stamps):
- Definition of Mild Cognitive Impairment (MCI; 1:38)
- How clinical samples may have influenced early definitions of MCI (6:50)
- How to advise patients in terms of pharmacological intervention for dementia (9:00)
- Examples of primary prevention vs. secondary prevention vs. tertiary prevention (13:26)
- Difference between restorative and compensatory cognitive training (17:22)
- What is the Healthy Action to Benefit Independence and Thinking (HABIT) program? (21:34)
- Difference between TBI and MCI cognitive remediation programs (25:15)
- Empirical evidence for HABIT (27:42)
- Other clinical populations in which HABIT could be effective (35:34)
- Differences between HABIT and PEACEOFMND (38:17)
- Translation of HABIT to clinical populations (41:33)
- Experience working with couples in the HABIT program (45:25)
- Implementation lessons from HABIT in clinical assessment and feedback (47:04)
- Smith’s thoughts on supervision and training in clinical neuropsychology (54:25)
- Smith’s emphasis on psychology skills in neuropsychology; being a neuroPSYCHOLOGIST rather than a NEUROpsychologist (58:48)
- Smith’s views on talking to trainees about failure (1:01:10)
- Bonus Questions (1:06:44)
About Glenn
Dr. Smith is currently Chair of the Department of Clinical and Health Psychology at the University of Florida. Dr. Smith completed his doctoral training at the University of Nebraska-Lincoln and completed his internship in gero-neuropsychology at UCLA. He went on to complete a fellowship in clinical neuropsychology at the Mayo Clinic, where he was Vice Chair for Research for the Department of Psychiatry and Psychology, then Neuropsychology Section Chair, and later Co-Chair of the Division of Outpatient Consultation Psychiatry and Psychology, as well as the Deputy Director of Post-Doctoral Education. He has been on the editorial boards of the Journal of the International Neuropsychology Society, Journal of Clinical and Experimental Neuropsychology, Neuropsychology, and The Clinical Neuropsychologist. He served as President of the American Board of Clinical Neuropsychology (ABCN) from 2005-2007 and President of the Clinical Neuropsychology Division (40) of APA. He was Chair of the Clinical Neuropsychology Synarchy and the APA’s Committee on Aging. He was recognized by AACN in 2016 with the Distinguished Neuropsychologist Award.
Resources
More about HABIT: https://gesmithlab.phhp.ufl.edu/the-habit-program/
Select References
De Wit, L., O’Shea, D., Chandler, M., Bhaskar, T., Tanner, J., Vemuri, P., … & Smith, G. (2018). Physical exercise and cognitive engagement outcomes for mild neurocognitive disorder: a group-randomized pilot trial. Trials, 19(1), 1-11
Greenaway, M. C., Hanna, S. M., Lepore, S. W., & Smith, G. E. (2008). A behavioral rehabilitation intervention for amnestic mild cognitive impairment. American Journal of Alzheimer’s Disease & Other Dementias®, 23(5), 451-461.
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G., & Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of neurology, 56(3), 303-308.
Petersen, R. C., Thomas, R. G., Grundman, M., Bennett, D., Doody, R., Ferris, S., … & Pfeiffer, E. (2005). Vitamin E and donepezil for the treatment of mild cognitive impairment. New England Journal of Medicine, 352(23), 2379-2388.
Smith, G. E. (2016). Healthy cognitive aging and dementia prevention. American Psychologist, 71(4), 268-275.
Smith, G. E., Chandler, M., Fields, J. A., Aakre, J., & Locke, D. E. (2018). A survey of patient and partner outcome and treatment preferences in mild cognitive impairment. Journal of Alzheimer’s Disease, 63(4), 1459-1468.
Smith, G. E., Housen, P., Yaffe, K., Ruff, R., Kennison, R. F., Mahncke, H. W., & Zelinski, E. M. (2009). A cognitive training program based on principles of brain plasticity: results from the Improvement in Memory with Plasticity‐based Adaptive Cognitive Training (IMPACT) Study. Journal of the American Geriatrics Society, 57(4), 594-603.
This was a great interview! I especially liked the discussion of “failure” as a training need in academics and the story of the dissertation mentor. Dr. Smith certainly seems to be one of the most humble, learned and wise. Might I ask for an email introduction or contact information for Glenn? I’m working on many of the same areas through NIA and would like to discuss with him.