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Lecture 8
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Cont from last weeks class
Approaches to cognitive rehab (examples of each are below)
•Adjustment to loss: adjust their vision to accommodate their problem
•Strategy building: providing a coping advice, like case management to help the per-
son with schizo
•Train the brain: target the problem and ignore the positive things, in order to improve
the problem
•Wisconsin Card Sorting Task (for last week): measures an error of perseveration -
mistakes where you are mentally stuck [demands of the task are changed, so you need
to adjust to it]
Case study: rose
•Diagnosed w/ schizo, treated w/ 2nd generation anti-psychotic medication, psychotic
symptoms in remission
•Underwent neuropsychological testing
•Found to have strengths in mental arithmetic and working memory, normal verbal
skills, avg. Intellect
•Participated in IPS (individual placement and supports) vocational program - subsidize
wages - three month support happens after job is found
•Job placement: in a variety store
•A week after, she was not able to do well in the job, bc she had to shift from many dif-
ferent places which she felt too overwhelmed
•They used the adjustment to loss approach, in order for her to start just at the
cash and eventually do more afterwards
Three brief videos - schizophrenia
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•Created by David Dartsch
•Hamilton Program Talent Show (HPS Talent Show) - HPS idol
•The videos demonstrated that David has fears about being outside on the street or be-
ing hurt; in the final film (of apes) it showed that he decided to seek help for his anger,
but felt a sense of betrayal [by being sent off to the zoo]
•The video showed a msg that David had problems with trust
•A common theme was that David always felt he was going to be hurt or victimized
by others
•People with skills <- support
•People without skills -> support
•Refer to coping with cognitive impairments
Collective kitchen supportive meal program
•Twice a month ppl would have planning meetings, and the next week the ppl would
cook together to make meals (around 8-10 meals for the next week)
•This allowed numbers of ppl to be able to live in their own apartment and not be im-
poverished: the only thing they needed on their own, was a microwave
•This strategy building approach was to allow a change in the patients schizo
•When working with someone with schizo, the goal is to tackle upto 3 problems a time:
known as the “client planning for change” - in this worksheet, you come up with goals
(known as personal criteria)
Case workers/case managers
•Helping individuals to plan, organize and manage demands on them to be flexible
•Case worker is like surrogate dorso-lateral prefrontal cortex
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