If you feel that your own efforts at adopting strategies and other self-help measures are not enough, you may wish to seek professional help. If you are under the care of a neurologist, you may wish to contact him or her directly. They may be able to refer you to someone who can offer you an assessment and therapy. If you are not under the care of a neurologist, you can ask your GP to refer you to a specialist MS Centre. The pattern and impact of cognitive deficits in MS is individual to the condition and you should request that you be seen by someone who is an expert on MS.
A range of professionals may be able to help you understand and mange your cognitive difficulties:
An Occupational Therapist (OT) is skilled in assessing how cognitive impairments may be impacting on your everyday life and suggesting ways of reducing this impact.
Occupational Therapist is a protected title, and anyone using this must be on the register held by the Health Professions Council. You can check whether your OT is registered using the search facility on the Health Care Professions Council's website.
Speech and Language Therapist
A Speech and Language Therapist (SALT) is skilled in assessing and treating communication and speech problems. The therapist can assess the cause and the impact of particular problems and develop programmes to provide effective management of symptoms. Referral to a speech and language therapist is usually made by a GP but most therapy services can also be contacted directly for advice. Speech and language therapists work in a variety of settings depending on a client's needs - in the community, people's homes and in hospitals. Visit the Royal College of Speech and Language Therapists website.
A clinical psychologist is skilled in understanding the impact that MS may have on your life.
The number of people calling themselves psychologists and offering psychological services is increasing. Some of these people have no recognised qualifications and are not answerable to any recognised professional body. The title Chartered Psychologist is a protected title. Both the Register and The Directory of Chartered Psychologists lists can be viewed online.
A clinical neuropsychologist is skilled in assessing the pattern and severity of a person’s cognitive impairments. They can develop individual treatment programmes based on cognitive neuropsychology, an evidence-based approach that models cognitive deficits and strengths to optimise function.
There is a “Find A Psychologist” section on the British Psychological Society website. You can look in the Directory of Chartered Psychologists to find a clinical psychologist or a clinical neuropsychologist in your area, by typing in your postcode. You can look in the Register of Chartered Psychologists to see if any particular psychologist is chartered, by typing in the name of the psychologist. You may be seen for part of the time by a trainee psychologist or psychology assistant, but they should be supervised by a chartered psychologist.
What happens when you meet a professional?
An important part of any assessment is to identify and understand what is the most troublesome problem that you are experiencing. It is likely that some formal assessments will be made of your mental abilities. These may seem like quizzes and puzzles. They might include remembering word lists, reading word lists, arranging pictures to tell a story, or remembering pictures or faces. These tests usually work by comparing your scores to people of your own age. You shouldn’t feel uncomfortable or worried about this. The first stage to making changes is to fully understand the problem. Various strategies will be tried and evaluated. Targets will then be agreed, to measure improvement in the area(s) that concern you most. If you are comfortable to involve others and give your permission, it may be appropriate to involve family members or even workmates in helping you manage your cognitive difficulties. Your cognitive problems may be affecting how well you manage your MS. If this is the case, it may be appropriate to involve other professionals (e.g. continence specialists, physiotherapists).