Originally published: . Volume 8, No. 3. Source pages: 11, 12.
Psychology Times, March 2017 – Page 11 Who’s Writing What? The Practical Guide to Cognitive Rehabilitation: Overcoming Cognitive Neurological Impairments
Kimberly S. Hutchinson, PhD, and Lawrence S. Dilks, PhD Lash & Associates Publishing/Training, 2015
Cognitive Rehabilitation of Executive Functions
Lawrence S. Dilks, PhD, and Kimberly S. Hutchinson, PhD Lash & Associates Publishing/Training, 2016
Two neuropsychologists and experts in rehabilitation, Dr. Kimberly Hutchinson and Dr. Lawrence Dilks, have created a line of books and educational tools that are practical, flexible, and informative aids for those working to help individuals with neurological injuries or impairments.
The Practical Guide to Cognitive Rehabilitation: Overcoming Cognitive Neurological Impairments, and Cognitive Rehabilitation of Executive Functions are two of their texts and workbooks, published by Lash & Associates, a specialty publisher who helps experts reach survivors, veterans, families, educators and caregivers, together with clinicians and therapists, so to support the most useful ways to aid in recovery.
The books are “… born of necessity,” write Hutchinson and Dilks, who note that they were faced “… with providing cognitive rehabilitation to both an inpatient and an outpatient setting. Additionally, patients, clients and families require explanations of the purpose and logic of the ongoing interventions and would frequently interrupt treatment to request information,” they write. “Many inpatient consumers obtained services for only a brief period of time, typically two to three weeks. The interventions were intense and commercially prepared products were rapidly extinguished as well as prohibitively expensive.”
Kimberly S. Hutchinson, PhD is a clinical and neuropsychologist with Counseling Services in Lake Charles, Louisiana and Physical Rehabilitation Services at Lake Charles Memorial Hospital. She graduated from Barry University, Villanova University, and Fielding Graduate University. She has taught at Barry and completed a fellowship in Neurocognitive Rehabilitation at Lake Charles Memorial Hospital. Hutchinson is a member of the free-standing Lake Charles Research Group and has a research interest in rehabilitation.
Dr. Larry Dilks is a clinical neuropsychologist in private practice with Counseling Services in Lake Charles and serves as the head of the Department of Neuropsychology with the Physical Rehabilitation Service at Lake Charles Memorial Hospital. He is a graduate of Truman State University, Kansas State at Pittsburg and the University of Southern Mississippi. Dr. Dilks served four years as an Army Clinical Psychologist and has taught at Northwestern and McNeese State Universities. For the last 37 years he has focused on helping individuals overcome psychological and cognitive impairments, always with the goal of helping the individual maintain as much independence as possible.
Together Hutchinson and Dilks have collaborated on a line of texts and learning tools that provides visual and cognitive activities and essential training exercises for clinicians and for those who are recovering from brain injury and related cognitive disabilities.
In The Practical Guide to Cognitive Rehabilitation: Overcoming Cognitive Neurological Impairments authors Hutchinson and Dilks provide a versatile program that can be easily adapted to different patient needs, settings and treatment goals.
In its 200 plus pages, and in a user friendly, practical format, the authors lay out activities that can be used to support the individual and different settings.
The workbook can be used by both individuals and caregivers, as well as clinicians and therapists, with exercises chosen to conform to and accommodate specific treatment efforts. The text is organized in a straightforward and easily understood rationale, with each section including explanations and then activities and worksheets of visual and cognitive exercises.
Practical Guide is divided into chapters on: 1) orientation, 2) attention and concentration, 3) processing speed, 4) memory, 5) executive functions, 6) language redevelopment, 7) visual perception, 8) anxiety and depression, and concluding with 9) extra activities.
“Out of necessity (some would suggest desperation),” the authors write that they began to develop cognitive rehabilitation worksheets based on the “available research surrounding brain injury, special education, developmental disorders and neuroscience.”
They explain that research directly related to outcomes for cognitive interventions is mixed and limited in scope and their hope is that this will improve in the future. Nevertheless, “The authors have discovered progress is most rapid and rapport at their best under the following circumstances: the therapist uses distributive practice, offers liberal verbal reinforcement, modifies activities as appropriate, focuses on practical outcomes, is personally involved, has a relationship with the family and is transparent in interventions.” They encourage, “Be creative and never give up.”
“Not all exercises will be appropriate for every client; therefore, pick and choose the exercises that best address the specific needs of the person you are working with,” the authors write.
Practical Guide includes activities for approximately two weeks, which is the average length of stay on a rehabilitation unit. The tasks included are specifically designed for intervention, not as assessment tools and should not be used for diagnostics. “Don't hesitate to modify a task if it benefits the consumer,” the authors encourage.
Cognitive Rehabilitation of Executive Functions by Lawrence S. Dilks, Ph.D. and Kimberly S. Hutchinson, Ph.D.
Another contribution to their growing list of publications for Lash, Drs. Hutchinson and Dilks have also developed a two-book set for interventions for executive functioning. Written for clinicians, Cognitive Rehabilitation of Executive Functions features practical intervention exercises involving the reconstruction of executive functions of the brain.
Using functional approaches, the authors address areas in the text. Chapter 1: Introduction, 2) attention and concentration, 3) processing speed, 4) categorization, 5) sequencing, 6) awareness and neglect, 7) working memory, 8) reasoning and judgment, 9) humor, 10) appropriate use of language, 11) planning ability, 12) impulse control and socially appropriate behavior, 13) problem- solving, 14) stress management, 15) anger management. These chapters are followed by extra exercises, a glossary, resources, and bibliography.
Each chapter begins with an overview, followed with a description of the area of functioning addressed. Exercises that can be performed by a paraprofessional or family member are included.
“Every exercise only takes a few minutes to complete and can be arranged to supplement other forms of intervention. All of the exercises have been developed and proven through years of practical application with inpatient and outpatient clients in rehabilitation,” write the authors.
One of the most popular items in the line of products by Drs. Dilks and Hutchinson is their “Tip Card.”
The Tip Card for Executive Functions After Brain Injury, is a short, direct educational method that can assist family members, caregivers, and others in working with individuals who have experienced brain injury. The Tip Card helps caregivers to understand the role of executive functions, understand how the executive functions influence the emotions, behaviors and thoughts of the person with a brain injury, and also helps to provide strategies on managing the emotions, behaviors, and thoughts of a person with a brain injury.
Executive Functions control activities such as managing emotions, attention, concentration, categorization, planning, sequencing, problem solving, impulse control, reasoning, and judgment, explain the authors.
The authors write: “The brain works in a unified way that allows us to take in information, process it, and act in a purposeful fashion. Purposeful behavior allows us to live safely in our environment, accomplish goals, and succeed to the best of our ability. Although the brain works in a unified way, it is controlled by complex systems. Executive functions are a major system involved in controlling brain function. Executive functions organize and prioritize actions and behaviors. When injury to the brain includes damage to executive functions, the ability to do things like plan, organize, make decisions, focus attention, and manage emotions may no longer function the way it did before the injury. Fortunately, there are ways to recover functions and work around behaviors that occur as a result of brain injury.”
Drs. Hutchinson and Dilks are both active participants in the Lake Charles Research Group, a free- standing group of independent, diverse researchers. Members of the group conduct research in their practices and present an array of work around the state and region, including national conferences.
The group was started about 17 years ago, and Dr. Dilks, one of the organizers, said, “It’s made up of different people every year. It’s a number of local psychologists, interns, post-doctoral fellows, practicum students, and then pretty much anybody else who’s just interested in publishing journal articles and doing presentations at conferences.”
The group presents research regularly, and has presented at APA Division for Rehabilitation Psychology, the National Association of Neuropsychology, Southwestern Psychological Association, LaMar Educational Research Conference, the Summer Symposium, and many others.
Dr. Dilks and Dr. Hutchinson have collaborated on topics such as, “Analysis of Clock Drawings in Cognitively Impaired Adults,” “Apathy in Alzheimer’s Disease: Associated with Executive Dysfunction?” and “A Study of Bilateral and Unilateral Left Hemianopsias: A Neuropsychological Perspective,” and “Are Brain Injuries Identified and Conceptualized in Psychotherapy with Children and Adolescents?”
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