BRS 214
Introduction to Psychology
2013-2014
Rehabilitation interventions and
clinical psychology
DAWN STEWART
BSC, MPA, PHD
Introduction to Psychology
Cognitive intervention or rehabilitation includes every
procedure that can help people with cognitive
impairments to successfully engage in activities that are
rendered difficult by those impairments.
Cognitive intervention/rehabilitation is a wide-ranging
and important field, and includes all of the intervention
and support procedures including Attention, Memory
and Memory Problems, Retrieval, Organization,
Problem Solving, Concrete Versus Abstract Thinking,
Instructional Routines, Executive Function/SelfRegulatory Routines.
Introduction to Psychology
Cognition refers to mental processes
Cognitive science is the interdisciplinary
scientific study of mind and its processes.
These processes include thinking,
Introduction to Psychology
There are at least two ways to classify cognitive
disabilities: by functional disability or by clinical
disability.
Functional disabilities ignore the medical or
behavioral causes of the disability and instead focus
on the resulting abilities and challenges.
Clinical diagnoses of cognitive disabilities include
autism, Down Syndrome, traumatic brain injury
(TBI), and even dementia
Introduction to Psychology
Some of the main categories of functional cognitive
disabilities include deficits or difficulties with:
Memory
Problem-solving
Attention
Reading, linguistic, and verbal comprehension
Math comprehension
Visual comprehension
Introduction to Psychology
The concept of cognitive disabilities is extremely broad,
and not always well-defined. In loose terms, a person
with a cognitive disability has greater difficulty with one
or more types of mental tasks than the average person.
Most cognitive disabilities have some sort of basis in the
biology or physiology of the individual. The connection
between a person's biology and mental processes is most
obvious in the case of traumatic brain injury and genetic
disorders, but even the more subtle cognitive disabilities
often have a basis in the structure or chemistry of the
brain.
Introduction to Psychology

Focus and Goals
 Traditional Cognitive Retraining:
The focus of intervention is on the underlying neuropsychological
impairment, with the goal of restoring cognitive functions (e.g.,
attention, organization, memory, reasoning, problem solving).
In this approach, residual cognitive skills are often utilized to
assist weakened abilities. Increasingly the focus of treatment has
come to include the use of compensatory strategies to augment
restorative interventions and maximize intervention techniques
across areas of functioning for the individual.
Cognitive remediation is often done outside of the functional
contexts or environments of the individual (e.g., in a hospital or
clinical setting).
Introduction to Psychology
 Context-Sensitive
 Cognitive Intervention and Support:
The focus of this approach is translating the underlying neuropsychological
impairments into their negative impact on the person's functional activities
in everyday life, and/or the individual’s participation in chosen life activities
(e.g., school).
Needed environmental adaptations and supports to make that participation
possible and successful are of primary importance, along with compensatory
strategies that might be of use to the student.
The primary goal is to help individuals achieve their real-world objectives
and participate in their chosen real-world activities that may be blocked by
cognitive impairments. I
In contrast to traditional cognitive remediation approaches, this intervention
is typically embedded within the person's natural environments (e.g., in the
home or classroom setting).
.
Introduction to Psychology
Traditional Cognitive Retraining:
Both diagnosis and treatment planning are based on
standardized neuropsychological tests, possibly
combined with customized laboratory tasks.
Testing identifies both cognitive strengths and
weaknesses, upon which interventions are based.
Outcome tends to be measured by similar tests at a
later point in treatment. More recently practitioners
working within the traditional framework have begun
to add measures of changes in functioning in realworld activities to their test batteries.
Introduction to Psychology
Context-Sensitive Cognitive Intervention and Support:
Assessment takes place across three levels of functioning:
 Impairment: Standardized neuropsychological measures are used,
with possible expansion of tasks to isolate the underlying processes that
are affected in poor performance.
 Everyday Activities: Assessment includes systematic behavioral
observations of everyday activities (static assessment) and exploration of
variables that affect functional performance of everyday activities
(dynamic assessment).
 Participation and Context: Surveys and reports of real-world
participation may be used (static assessment) along with exploration of
context variables that affect functional participation (dynamic
assessment). The latter includes systematic behavioral observations of
the competencies of those individuals providing the student with
everyday supports (e.g., classroom assistants) as well as systematic
attempts to improve those competencies.
Introduction to Psychology
There are many services rehabilitation psychology provides.
There is health and behavior consultation. This allows one
to learn about information on a particular health condition
and how it can affect one’s life.
Counseling and psychotherapy. This is geared towards
influencing one’s attitudes and emotions with the need to
change one’s behavior.
Cognitive remediation is a service that helps an individual
achieve cognitive abilities necessary with school or work, or
their life in general, and is important in their practice of
independence in the community as well.
Introduction to Psychology
Treatment Modalities and Methods
 Traditional Cognitive Retraining:
Retraining relies largely on focused cognitive exercises
designed to restore impaired cognitive processes or
skills.
These restorative exercises may be combined with the
use of compensatory cognitive strategies to bypass
deficits and augment cognitive functioning in daily
activities.
Family members or others may be involved in
treatment to help generalize and practice techniques
learned in remediation to the home and community
setting.
Introduction to Psychology
 Context-Sensitive
 Cognitive Intervention and Support:
Intervention and support includes flexible combination
of cognitive exercises (if indicated and supported by
evidence), task-specific training of relevant everyday
skills, and intervention for strategic thinking and
compensatory behavior in functional contexts.
A critical intervention modality in this approach is
environmental modifications, including changes in the
support behaviors of relevant people in the individual’s
natural environments (e.g., in home or school).
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