How to Do Cognitive Rehabilitation Therapy

How to Do Cognitive Rehabilitation Therapy

Kit Malia, B.Ed. and Anne Brannagan, DIPCOT
Cognitive Rehabilitation Manuals for adolescents and adults with acquired brain injuries are for clinicians and caregivers in rehabilitation, schools and community programs.
Item: CRT
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Full Description

A Cognitive Rehabilitation Therapy Program for Traumatic Brain Injury

These two manuals take a practical hands on “How to” approach to cognitive rehabilitation therapy (CRT). They have been written specifically for therapists and families working with and living with persons with brain injury and have an easily readable format with user-friendly text.

This second edition of these popular manuals has taken material that has been widely used in the United Kingdom and Europe and adapted it for North American readers. The information is solidly grounded in published research findings from around the world and on the authors’ clinical work as international experts on cognitive rehabilitation therapy.

Part 1 explains the theoretical underpinnings for how to do CRT.

The Introduction discusses "What is cognitive rehabilitation therapy?" and "Why treat cognitive problems?"

Section on Principles describes how the brain works and the importance of structure and practice. Metacognition is discussed along with insight and awareness. The interaction between cognition, emotions and behavior is described. Examples of the therapeutic milieu and goal setting are given.

Section on Assessment and Treatment covers how to conduct an assessment and gives detailed treatment approaches for education, process training, strategy training and functional activities training.

The Evaluation section identifies issues to consider, examines the efficacy of CRT and shows how to measure outcomes.

Part 2 describes how to make the theory work with plenty of case examples. Five detailed cognitive treatment modules are presented on attention, visual processing, information processing, memory, and executive function. The final section explains how to CRT in different settings with various diagnostic groups.

These manuals can be used in schools, home, rehabilitation programs, and community agencies. They provide…

  • practical information on cognitive rehabilitation therapy for individuals with brain injury, their caregivers and staff working with them
  • translation of research findings into tools and strategies for everyday practice

See other manuals by Kit Malia and Anne Brannagan including...

  • A Hero's Journey
  • Procedure for Assessing Awareness & Adjustment Following Brain Injury
Details
Item CRT
ISBN# (Part 1) 1-931117-39-X (Part 2) 1-931117-40-3
Pages (Part 1) 188 pgs, 8 ½ x 11, softcover, perfect bound (Part 2) 176 pgs, 8 ½ x 11, softcover, perfect bound
Year Second edition, 2006

Authors

About the Authors

Kit Malia, BED, MPhil, CPCRT, is the only Certified Cognitive Rehabilitation Therapist in the United Kingdom (via the Society for Cognitive Rehabilitation, USA). He holds a research degree in Neuropsychology. Initially trained as a teacher for people with learning disabilities, he has spent almost 19 years working as a cognitive rehabilitation therapist with adults who have acquired neurological injuries at The Defense Medical Rehabilitation Center, one of the largest brain injury rehabilitation units in the UK.

Mr. Malia has published scientific papers on cognitive and psychosocial rehabilitation, and clinical standards in brain injury rehabilitation. He is the primary author of Brainwave-R (an extensive collection of cognitive strategies and techniques for brain injury rehabilitation). He has also co-authored The Brain Injury Workbook with Dr Trevor Powell.

Mr. Malia has lectured at various conferences in Canada, USA, Sweden, Norway, Denmark, Finland, The Netherlands, Slovenia and the UK. He is also on the Board of Directors for the Society for Cognitive Rehabilitation, USA, and is the chairperson of the International Division for the SCR.

Ms Anne Brannagan, DIPCOT, MSc, Clinical Specialist, qualified as an Occupational Therapist in 1988 from the London School. She did a two year orthopedic rotation before specializing in Neurorehabilitation at the Defense Services Rehabilitation Center in Headley Court. She gained a research master's degree from Kings College in 1993.

Ms Brannagan is particularly interested in the cognitive and executive sequelae of acquired brain injury. She runs workshops with Kit Malia, training both professionals working in the field and caregivers of individuals with brain injury around the country. In addition, she has lectured on cognition at conferences in the UK, Sweden, Norway, Denmark, Finland, The Netherlands and the USA

She is currently the membership chair of the Society for Cognitive Rehabilitation. She also is the chair of the National Executive Committee of NANOT and is deputy chair of the brain injury forum. Ms Brannagan has developed a number of rehabilitation activities, including a practical approach to the assessment of executive problems (The Brannagan Executive Functions Assessment) following brain injury and cognitive/psychosocial groups.

Contents

HOW TO DO COGNITIVE REHABILITATION THERAPY: A GUIDE FOR ALL OF US -PART ONE
SECTION 1: INTRODUCTION “SO WHAT'S IT ALL ABOUT?”

Chapter 1 Why we wrote this book
The need for practical information
The requirement to deal with cognitive problems
The physical bias of rehabilitation – “Descartes error”
The need to translate theory into practice
Who is this book for?
Continuous professional development

Chapter 2 What is Cognitive Rehabilitation Therapy (CRT)?
What is cognition?
Who has cognitive problems?
What is CRT?
The 4 components of CRT
Cognitive therapy vs. cognitive rehabilitation
Limitations of CRT
Bottom up or top down
Who can do CRT?
The need for CRT to cross disciplinary boundaries
The need for all staff to understand cognition
An integrated model of CRT
How do staff get trained?
What makes a good cognitive rehabilitation therapist?

Chapter 3 Why Treat Cognitive Problems?
Because brain injury is common
Because cognitive problems are very common
Because cognitive problems persist
Because they prevent independent living
Because they can get worse
Because they cause major family problems
Because the brain is plastic

Chapter 4 The History of CRT
Our hall of fame
Our guiding principle
Where has CRT come from?

SECTION 2: BASIC PRINCIPLES

Chapter 5 Understanding How The Brain Works
Overview of the brain
The 4 major components
The 4 lobes
How does the brain work?

Chapter 6 The Importance Of Structure
Why is structure important?
Different levels of structure
Simplifying the complexity of cognition

Chapter 7 The Importance Of Practice
How we learn new skills
The well trodden path
The postal sorting office
What happens after brain injury - finding a new path

Chapter 8 Metacognition
Defining metacognition
Why do we need metacognition?
Building metacognition into the exercises and strategies

Chapter 9 Insight / Awareness
The importance of awareness - the golden key
A practical model - how to understand awareness
Different types of awareness
Acceptance
Self concept

Chapter 10 The Interaction Between Cognition, Emotions And Behavior
What are psychosocial skills?
Interaction - it's a two way street

Chapter 11 Therapeutic Milieu
CRT as part of a multidisciplinary approach

Chapter 12 The Importance Of Goal Setting
Goals are the directors
SMART goals
Examples of goals

SECTION 3: ASSESSMENT AND TREATMENT

Chapter 13 How To Assess
What is the purpose of assessment?
Types of assessment
Important points about assessment
Selecting the right test
Guidelines for test administration
Repeatable batteries

Chapter 14 Treatment Approach #1: Education
The need for education
You are a teacher
The content of an educational program
 
Chapter 15 Treatment Approach #2: Process Training
Process training - what is it?
The process training cycle
Does process training work?
The systems approach
Scientific efficacy
How does process training work?
Examples of process training
How to design tasks for process training
Ideas of how to grade activities

Chapter 16 Treatment Approach #3: Strategy Training
The use of strategy training
The difficulties with strategy training
The benefits of strategy training

Chapter 17 Treatment Approach #4: Functional Activities Training
The end of the rainbow
Using functional activities to improve cognition
Some issues related to functional activities training
How to use functional activities to treat cognitive problems

Chapter 18 Integrating The 4 Treatment Approaches
Integration of the 4 approaches to CRT

SECTION 4: EVALUATION

Chapter 19 Issues To Take Into Account
Impairment, activity limitation or participation?
How does cognition fit into this model?
Well being
Sources of knowledge informing outcome
Phrasing the correct question
Biased opinions
Difficulties with comparisons between experiences or studies

Chapter 20 The Efficacy Of CRT
But is CRT valuable?
Flaws of the studies
To be aware, or not to be aware
Therapist/researcher role
Summaries of the 6 reports, 1999-2005
 
Chapter 21 Measuring Outcomes
Standard outcome measures
Goal achievement
Reassessment on standardized tests
Goal attainment scaling
Quality of life/Patient or caregiver satisfaction reports
Functional gains
 
Conclusion
 
HOW TO DO COGNITIVE REHABILITATION THERAPY: A GUIDE FOR ALL OF US - PART TWO

SECTION 1: USING THE COGNITIVE TREATMENT MODULES

Chapter 1 The 5 Cognitive Modules
Simplifying the complexity
Why we have simplified cognition
What are the 5 modules?

Chapter 2  Organization Of The 5 Cognitive Modules
Using models to explain cognitive function
A model helps us conceptualize
Why do we use models?

Chapter 3 Attention
Start at the very beginning
Components of attention
Neural networks of attention
Education about attention
Tips on how to educate patients
How to assess attention
How to treat attention problems
 
Chapter 4 Visual Processing
What is visual processing?
The top down approach
A model of visual processing
How to assess visual processing skills
How to treat visual processing problems

Chapter 5 Information Processing
What is information processing?
A model of information processing
How to assess information processing
How to treat information processing problems

Chapter 6 Memory
What is memory?
An information processing model of memory
Working memory
How to assess memory
How to treat memory problems
 
Chapter 7 Executive Functions
What are executive functions?
Components of executive functions
A model of executive functions
The link with information processing
Understanding the model
How to assess executive functions
How to treat executive functions

SECTION 2: ADAPTING CRT TO YOUR SPECIFIC SITUATION

Chapter 8 How To Do CRT In Different Settings
The Slinky model
Doing CRT in the acute setting
Doing CRT in the post acute setting
Doing CRT in the home/community setting
Doing CRT in support groups
Doing CRT in long term care settings

Chapter 9 How To Do CRT With Different Diagnostic Groups
Doing CRT with people following stroke
Doing CRT with minimally responsive patients
Doing CRT with children
Doing CRT with people with progressive conditions
Doing CRT with the elderly

CONCLUSION
The Way Forward

Excerpts

Section 1: Introduction

We have provided Cognitive Rehabilitation Therapy (CRT) for people with acquired brain injury (ABI) over the last 23 years. The causes of these brain injuries have been varied, as have the settings in which we have provided this work (schools, home, inpatient rehabilitation centers, community settings, and support groups). During this time we have seen the value of cognitive rehabilitation for these individuals. We have become passionate about the need for Cognitive Rehabilitation Therapy and strive to ensure that people with brain injury, family members and therapists understand this crucial area of intervention.

We have done this by running practical training courses in Cognitive Rehabilitation Therapy (CRT) for therapists, relatives, care workers and support groups over the last 8 years around the world, and by producing materials that can be used by these groups of people. As of 2005, a total of 6500 people have been trained on the 145 courses, which have been run throughout the UK, Europe and USA.

Writing down our experiences in a book that can be used by others to improve the cognitive skills of individuals with acquired brain injury seemed the next logical step. The need for this book was underpinned by 4 other factors:

(a) A reported need for practical information on cognitive rehabilitation for individuals with brain injuries, their caregivers and the staff working with them

(b) A recent requirement to address cognitive issues according to both the National Clinical Guidelines for ABI and the National Clinical Guidelines for Stroke (2nd Edition)

(c) The continued bias of traditional brain injury rehabilitation towards physical rather than cognitive skills

(d) The observation that therapists and relatives need help to translate research findings into everyday practice

It has become evident to us that there is a need for a practical hands on “How to Do Stuff” manual. The information provided in this book is solidly grounded in the published research findings from around the world, and also on our personal experiences. We have applied everything that is in this book in our own clinical practice during the last 23 years. It Works!

Ideally this book should be read in conjunction with the wealth of publications that focus on the theory – the ‘why’.

So…This is a HOW Manual to complement the WHY Materials.'

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