Accommodations for Cognitive Impairments

Below shows examples of proposed accommodations for possible cognitive impairments in the course of providing Cognitive Behavioral Therapy for Traumatic Brain Injury (CBT-TBI). Click on the images below to learn more.

Slowed speed of information processing and responding

• Present information at slower rate
• Speak slowly
• Allow patient more time to respond
• Check for understanding

Impaired attention and concentration

• Minimize environmental stimulation and distractions during session
• Focus on one topic at a time
• Frequently repeat and summarize key points
• Use shorter sessions

Impaired learning and recall

• Provide written summary of session
• Review concepts and strategies from prior session
• Assign simple written homework between sessions
• Focus on process and practical steps of CBT

Impaired verbal abilities

• Minimize emphasis on verbally mediated aspects of CBT
• Emphasize behavioral activation and pleasant events scheduling

Impaired initiation and generalization

• Include support person in treatment planning
• Reinforce scheduling activities
• Devote 2 sessions to generalization and relapse prevention at end of intervention

Impaired motivation

• Use motivational interviewing techniques to engage patient
• Focus on depression mitigating tasks that are intrinsically rewarding
• Make reminder call prior to each session
• Maintain flexibility to accommodate patient preferences