The Multicontext Approach for Cognitive Rehabilitation

The multicontext approach is a complex and multi-component metacognitive strategy intervention derived from the dynamic interactional model of cognition. Occupational performance is viewed as the ongoing interaction between internal or personal factors and external factors such as activity demands and the environment or context. The multicontext approach focuses on optimizing personal factors such as cognitive strategy use, self-awareness, and regulation of performance and self-efficacy while at the same time adjusting activity demands, changing the context or varying the physical environment, and utilizing guided learning methods from a skilled therapist (social environment) to promote successful performance and transfer or generalization of learning. The person’s context, including their culture, significant others, social interactions, or home and community environments, is incorporated into treatment whenever feasible to ensure that the person’s social and cultural context supports cognition and functional performance. The multicontext approach suggests that independent occupational participation and engagement require recognizing one’s limitations, self-monitoring performance, and using efficient cognitive strategies to manage everyday challenges.