.svg)
When people first hear about Cognitive Stimulation Therapy (CST), they often picture puzzles or quizzes. While those might be part of the programme, CST is far richer and more purposeful than that. At its heart are carefully structured sessions designed to stimulate memory, language, reasoning, and creativity, all within a social, engaging environment that builds confidence and wellbeing.
This article explains what the activities in CST actually look like, why they’ve been chosen, and what makes them effective. It also explores what happens if you deviate from the recommended structure, helping care home managers understand why fidelity to the CST model matters.
Every CST activity has two layers of purpose. The first is cognitive: to gently exercise the brain and encourage different kinds of thinking - remembering, reasoning, categorising, and using language. The second is social: to stimulate conversation, laughter, and a sense of belonging. The evidence shows that the combination of mental challenge and social connection has a more powerful impact on cognition than either one alone.
Each session is built around a theme, such as “current affairs”, “word games”, “music and discussion”, “childhood memories”, or “using money.” These aren’t random choices - they’re designed to draw on long-term memory, which often remains strong in people with dementia, while subtly encouraging new thinking and expression.
A typical CST group meets twice a week, for about 45 minutes. The group includes around six to eight participants with mild to moderate dementia. The sessions follow a consistent rhythm: an introduction and warm-up, a main activity around a theme, and a closing reflection.
An example session might start with a “word association” warm-up, followed by a discussion about a familiar topic such as the seasons, food, or music. The facilitator gently prompts participants to share opinions or memories “What’s your favourite song from when you were young?”- while ensuring everyone is included and supported. Activities often include visual or tactile aids, like pictures, objects, or music, to trigger memories and conversation.
CST activities are built on decades of psychological research. Studies have found that structured cognitive engagement can slow the decline of memory and thinking skills in dementia. When combined with social interaction and positive emotions, the brain releases neurotransmitters that support cognitive function and mood.
Unlike brain training or memory tests, CST avoids anything that feels like “testing.” Participants aren’t judged on performance; they’re simply encouraged to think, reminisce, and interact. This creates a sense of achievement and confidence - key ingredients in maintaining wellbeing for people living with dementia.
Some of the most common themes include:
Every session has a balance: a bit of challenge, a bit of comfort, and plenty of conversation.
Research from University College London, where CST was developed, shows that the benefits of CST come from both what is done and how it is delivered. If a care home uses the name “CST” but runs unstructured or improvised sessions, they may not achieve the same outcomes. The order of activities, the tone of facilitation, and the frequency, usually twice a week, are all part of the formula that makes CST effective.
Using structured guides or digital tools like the Ayla platform from Brain+ helps homes stick to the evidence-based framework while making delivery easier and more consistent.
Some flexibility is important - every resident group is different. Facilitators can adapt sessions to suit mobility, language, or cultural background, but should avoid removing key cognitive or social elements. For example, simplifying materials for someone with visual impairment is fine; skipping the discussion altogether is not, because conversation is where much of the therapy happens.
Care homes that deliver CST consistently report improvements in residents’ alertness, confidence, and mood. Participants often become more talkative and engaged, sometimes surprising family members who thought conversation had been lost. Staff also notice that residents who attend CST groups show fewer signs of distress or agitation.
The benefits go beyond individual residents. When a home runs regular CST sessions, it fosters a positive, stimulating culture. Staff feel proud of delivering a recognised, evidence-based therapy, and families feel reassured that their loved one is receiving active cognitive support.
If the therapy becomes inconsistent - say, sessions are cancelled, or the facilitator changes without proper training, the benefits can drop off. Residents may become less engaged, or new facilitators may unintentionally turn sessions into general activities. That’s why training and support are crucial, and why digital tools that guide each session can help maintain quality.
Cognitive Stimulation Therapy activities are simple, friendly, and fun, but they’re also deeply rooted in science. They work because they combine cognitive challenge, social interaction, and emotional warmth. When care homes follow the structured approach, the results can be transformative for residents, staff, and the home’s overall quality of care.
.svg)
