The multimodal approach to cognitive rehabilitation

In the past two decades, researchers and practitioners have developed many procedures to improve cognitive functioning. Most of these procedures attempt to produce a change in a client's cognitive processes. For example, clients may be trained in how to pay attention, perceive, rehearse, remember, or think through a problem. Recently, several researchers and practitioners have sought an eclectic approach to treating practical problems of cognition. Clients are not only trained in mental strategies to enhance cognition, they are also equipped with mental prostheses, counseled on how to cope with the stress of cognitive tasks, directed to consume foods and vitamins conducive to good brain chemistry, and taught social skills that augment cognitive performance. This article presents a model that provides a theoretical backdrop for the eclectic approach to cognitive rehabilitation. This approach is rooted in the theoretical assumption that cognitive performance can be influenced by other modes of psychological processing (e.g., physiological, perceptual, emotional, motivational, social, and responses to the physical environment). According to this approach, cognitive rehabilitation achieves the greatest improvement in a client's cognitive functioning (1) by training better thought processes, and (2) by interventions that enhance two or more other modes of processing. The article demonstrates that this multimodal model of cognitive rehabilitation accounts for a wide variety of findings in basic research and clinical research, as well as being consistent with clinical judgment.