Improvements in cognitive functioning following intensive behavioural rehabilitation

Serial evaluation of intelligence tests performed with long-term patients in psychiatric hospitals frequently reveal deterioration in cognitive functioning. Despite early success in the amelioration of cognitive symptoms of schizophrenia, little effort at cognitive remediation is currently directed to long-term psychiatric patients. In contrast, in the brain injury rehabilitation community, cognitive remediation is strongly supported despite mixed results in clinical literature. Within this context, individuals with brain injury in psychiatric hospitals may have little prospect of receiving cognitive remediation services. Utilizing performance on intelligence testing spanning 20 years, the following study evaluates changes in cognitive functioning of a severely brain injured individual, who had been replaced in a long-term psychiatric hospital and treated in an intensive behavioural rehabilitation programme. Results found that the patient demonstrated a significant improvement in overall verbal and nonverbal cognitive functioning during treatment. These improvements were maintained for a 1-year period. It was suggested that the use of 'low tech', small group interventions, within intensive behavioural rehabilitation programmes, may lead to the recovery of cognitive functioning for individuals who are significantly post-injury.