Memory and Attention Adaptation Training

Abstract

Memory and Attention Adaptation Training (MAAT) is a cognitive-behavioral therapy (CBT) designed to help cancer survivors self-manage and mitigate the late and long-term effects of cancer and cancer therapy on memory function. Cancer-related cognitive impairment (CRCI) is a set of mild to moderate memory and attention impairments that can have an adverse influence on quality of life. CRCI symptoms tend to present during active treatment, but for some individuals cognitive changes can persist for years. While the exact prevalence of CRCI is unknown, review of the literature estimates that nearly half of all survivors may experience some form of CRCI. Causes of CRCI are multiple and are the subject of continued research. Chemotherapy, genetic vulnerability, neurovascular damage, inflammation, and hormonal/endocrine disruption have all been identified as candidate mechanisms of persistent cognitive change. Given the multiple causal mechanisms, finding a biomedical treatment for CRCI remains elusive. MAAT was developed as a CBT to help cancer survivors make adaptive behavioral and cognitive changes to improve performance in the valued activities that CRCI hinders. MAAT consists of eight visits and has been designed for administration through telehealth technology, improving access to survivorship care that so many cancer survivors may lack after the time and expense of cancer treatment. Survivors are provided a workbook they can use to work with their clinician and to reinforce learning and adaptive coping. This clinician manual guides the clinician step by step on MAAT administration and provides background on the theoretical underpinnings of CRCI and MAAT.