Rationale: Cognitive rehabilitation therapy (CRT) is a treatment approach used for patients with traumatic brain injury (TBI) that focuses on improving cognitive impairments on attention, memory and learning, affect and expression, problem solving, and executive function.

Technology Description: CRT is most often used as part of a comprehensive, multidisciplinary program that also involves traditional speech and language therapy; occupational, behavioral, and psychosocial rehabilitation; and cognitive therapy. The actual program of cognitive remediation is individualized, depending on the extent and severity of injury and type of cognitive deficit, but often includes group therapy as well as individual training.

Controversy: There are conflicting findings in the primary and secondary literature regarding CRT.  Some studies have identified specific CRT interventions that may improve outcomes for study participants. However, specific study weaknesses around design of the study, outcome selection, small sample size, and differences in intervention strategies impede the generalizability of evidence on this topic.

Key Questions

  • Does cognitive rehabilitation improve performance on measures of cognitive function (e.g., attention, language or communication, memory, visuospatial skills, executive function) in patients with TBI?
  • Does cognitive rehabilitation provide health benefits or improve daily functioning of patients with TBI?
  • Have definitive patient selection criteria been established for the use of cognitive rehabilitation for TBI?

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