The Impact of Clinician-Directed Engagement Practices on Cognitive Performance & Perceptions of Alliance among Individuals with Acquired Brain Injuries
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Date
2024-01-10
Authors
Rothbart, Aaron
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Publisher
University of Oregon
Abstract
While clinical engagement is widely considered to be essential to the rehabilitation process, little empirical evidence exists examining the influence of engagement-enhancing practices on clinical performance. This dissertation study sought to evaluate the impact of a set of clinician-driven engagement practices, targeting key affective states, that practitioners can feasibly embed into rehabilitation sessions whose primary purpose was to improve cognitive- linguistic performance. A concurrent multiple-baseline design was implemented to determine changes in cognitive performance on a series of common neurorehabilitative tasks following exposure to identified practices across four participants who previously sustained acquired brain injuries. Examination into perceptions of therapeutic alliance, motivation, and self-efficacy were analyzed to determine perceptual shifts following exposure to engagement practices. The results suggest that promoting clinical engagement using a series of clinician-driven engagement practices enhanced participant performance. Improved performance was noted across all tasks, for each participant. While a single participant demonstrated a positive shift in perceived alliance, motivation, and self-efficacy, the remaining participants provided mixed responses. This study provides preliminary evidence that rehabilitation professionals can systematically implement specific engagement-enhancing techniques and strategies that result in improved clinical outcomes.
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Keywords
brain injury, engagement, motivation, rehabilitation, self-efficacy, therapeutic alliance