The relationship of cognitive retraining to neurological patients' work and school status.
OBJECTIVE
To explore the relationship of cognitive retraining performance to discharge productivity status.


METHODS
One hundred and one brain-injured patients from a holistic milieu-oriented work/school re-entry programme.


METHODS
Initial, last, mean and best cognitive retraining scores; cognitive retraining behavioural checklist ratings; and working alliance scores.


RESULTS
Most (82.2%) of the sample returned to paid work or school. Better performance on two cognitive retraining tasks addressing information processing speed, visual scanning, visuospatial skills and memory were associated with return to the same level of work/school with and without modifications. Selected process variables related to the patients' behavioural approach to cognitive retraining tasks (e.g. their use of compensations, organizational and abstraction skills, procedural skills and unassisted task recall) were associated with better work/school outcomes. Patients' positive working alliance ratings related to their behavioural approach to cognitive retraining tasks. This highlights the importance of combining interventions targeting both the therapeutic interactive process and skill remediation to maximize work/school reintegration.


CONCLUSIONS
Cognitive Retraining exercises that incorporate both process variables and metacognitive skills, as well as a better working alliance with patients, positively related to return to work and school at the time of discharge from a holistic milieu-oriented programme.
Klonoff
Pamela S
PS
Catholic Healthcare West, Barrow Neurological Institute, Centre for Transitional Neurorehabilitation, Phoenix, AZ, USA. pamela.klonoff@chw.edu
Talley
Melanie C
MC
Dawson
Lauren K
LK
Myles
Stephen M
SM
Watt
Lisa M
LM
Gehrels
Jo-Ann
JA
Henderson
Steven W
SW
D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation; D004651:Employment; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008606:Mental Processes; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D012047:Rehabilitation Centers; D012574:Schools; D016896:Treatment Outcome