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Understanding our neurocognitive services

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What is Cognitive Functioning?

Cognitive functioning (neurocognitive functioning) refers to the brain’s ability to process information, learn, remember, and interact with the world around us. This includes how we focus our attention, absorb, and retain information, solve problems, make decisions, and apply knowledge in real-life situations. These mental abilities help us manage tasks at home, work, school, and in our relationships.

Cognitive dysfunction occurs when there is a disruption in how effectively the brain processes information. It can show up as slower thinking, difficulty staying focused, struggling to complete tasks, or trouble adapting to new situations. These challenges can affect daily functioning – especially in work, academic, and social settings.

Cognitive Remediation Therapy (CRT), also known as cognitive rehabilitation or neurorehabilitation, is a structured, goal-oriented treatment designed to improve cognitive performance and general, daily functioning. CRT helps individuals strengthen key areas such as:

  • Attention and concentration

  • Memory and information retention

  • Problem-solving and reasoning

  • Planning, initiation, and organization

  • Self-awareness and self-monitoring

Treatment plans are personalized and may include:

  1. Reinforcing cognitive strengths to support weaker areas

  2. Learning new ways to approach and organize tasks

  3. Strengthening focus through targeted exercises

  4. Using memory strategies to improve retention

  5. Empowering clients by helping them understand and work with their cognitive profiles

The ultimate goal is to enhance cognitive functioning and improve quality of life.

Neuroplasticity is the brain’s natural ability to adapt, grow, and recognize itself by forming new neural connections. This process continues throughout life and plays a key role in memory, learning, and cognitive resilience.

CRT leverages neuroplasticity by using targeted cognitive strategies and exercises to activate and strengthen specific brain regions – especially those involved in executive function and memory, such as the frontal lobe and hippocampus. Just as physical exercise builds muscle, CRT stimulates brain function, helping individuals regain or enhance mental performance.

While traditional psychotherapy often focuses on emotions, relationships, and mental health symptoms, CRT specifically targets cognitive performance. CRT may include emotional components, especially if they relate to cognitive barriers (such as anxiety about memory loss or ADHD), but the central goal is to help patients function better in everyday life – at work, in school, or in managing routines.

Yes, emerging research shows that ketamine – especially at low (sub-anesthetic) doses – can enhance neuroplasticity, which supports cognitive improvement. Ketamine affects glutamate pathways in the brain, which are directly linked to learning and memory.

In addition to boosting neuroplasticity, ketamine often improves mood, which is crucial since depression and anxiety can negatively impact cognitive performance. These dual benefits make ketamine a promising option for individuals with cognitive difficulties related to attention, executive functioning, or emotional health.

One psychological mechanism of ketamine is what researchers call “ego dissolution” – a temporary loosening of one’s usual sense of self. This occurs due to changes in the brain’s Default Mode Network (DMN), which is responsible for self-referential thinking and rumination.

When the DMN is quieted, individuals may experience expanded awareness and a broader perspective. This state can help reduce limiting beliefs, enhance creativity, and support novel problem-solving. By stepping outside habitual thought patterns, people often make new connections and gain clarity that’s harder to reach in ordinary states of mind.

This is why many describe the ketamine experience as “finding yourself by losing the self.”

CRT-K is Acheron’s unique approach that combines Cognitive Remediation Therapy with the therapeutic effects of ketamine. This integrative model supports patients with attention, memory, and executive functioning difficulties – especially those related to ADHD, trauma, or mood disorders.

CRT-K includes:

  • Guided ketamine sessions to enhance insight and neuroplasticity

  • Clinician-supported preparation using reflective, strength-based questions

  • Post-ketamine integration sessions focused on executive function, self-awareness, and performance strategies

The goal is to shift unhelpful cognitive narratives, build confidence, and improve functional outcomes through a neuroscience-backed, emotionally supportive process.

Executive functions are the mental skills we use to organize, plan, initiate, and monitor our behavior. They help us set goals, make decisions, manage time, and adapt to changing circumstances.

Executive functions fall into two major categories:

  • Organizational Functions: Gathering and processing information, prioritizing tasks, and making action plans

  • Regulatory Functions: Monitoring behavior, controlling impulses, shifting attention, and adapting responses

Strong executive functioning supports productivity, emotional regulation, and cognitive flexibility – making it essential for daily life in today’s fast-paced world.

Executive functioning and attention are closely linked. In fact, ADHD (Attention Deficit Hyperactivity Disorder) is considered a form of executive dysfunction.

Core attention skills include:

  • Selective Attention – Focusing on relevant information and filtering distractions

  • Sustained Attention – Maintaining focus over time

  • Working Memory – Holding and manipulating information in real time

These abilities all require executive control – deciding what to focus on, when to shift gears, and how to stay on track. CRT helps individuals strengthen these systems, leading to greater control, self-efficacy, and adaptability.

Executive dysfunction can occur when our brain’s higher-level thinking systems – called executive functions – aren’t working as effectively as they should. These abilities help us manage tasks, stay organized, make decisions, and regulate our behavior.

Executive functions are sensitive and require energy, alertness, and mental clarity to work well. Fatigue, illness, medications, or medical conditions can all reduce our ability to use these functions. Similarly, when we’re feeling anxious or depressed, emotional overwhelm can take up the mental bandwidth needed for focus and planning.

In some cases, people fall into a cycle: frustration about attention or planning issues leads to more stress, which only worsens cognitive performance.

It’s only importance to know that executive functioning isn’t something everyone just “grows into.” Unlike memory or language, it must be learned. Some people naturally pick up these skills through early role models – others may not. If these abilities were never taught or modeled, even people with strong memory or intelligence can still struggles with executive functioning.

Yes – executive dysfunction and attention difficulties are treatable. Cognitive Remediation Therapy (CRT) offers a structured, evidence-based way to strengthen attention, organization, and mental flexibility.

A core technique in CRT is metacognition – learning to think about how you think. Together, we examine how you approach tasks and build strategies to support better self-monitoring, problem-solving, and goal-setting. Over time, this helps you develop an “inner script” or mental roadmap to guide and regulate behavior.

Some specific strategies used in CRT for attention and executive function include:

  • Sustained Attention: Gradual attention-building tasks and mindfulness techniques

  • Working Memory: Repetition drills, memory chunking, and external aids like apps or notes

  • Task-Switching (Set Shifting): Practice with switching tasks smoothly and using visual cues

  • Prospective Memory: Digital calendars, reminders, and task tracking tools

  • Organization: Step-by-step breakdowns of complex tasks

  • Planning & Sequencing: Use of planners, goal-setting frameworks, and backward planning

  • Time Management: Time-blocking, visual timers, and prioritization tools

  • Problem Solving: Scenario-based exercises and real-life simulations

With consistent practice and support, individuals can regain control over their cognitive processes and feel more capable and confident in daily life.

A neuropsychological evaluation is a comprehensive assessment that measures various aspects of brain function, including:

  • Attention and executive function

  • Processing speed

  • Language and communication

  • Memory and learning

  • Social cognition and emotional processing

This evaluation helps identify cognitive strengths and challenges, clarify diagnoses, and guide personalized treatment planning. It’s often the first step before beginning CRT or CRT-K, offering a detailed understanding of how the brain is functioning and what support is most beneficial.

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