Metacognitive Framework

Most cognitive treatments in the Virtual Rehab Center are accompanied by the metacognitive framework, a set of pre- and post-treatment questions to promote insight and awareness (also referred to as metacognitive knowledge). Before the treatment, you will be asked one of the following questions:

  1. How difficult do you think this treatment will be today?
  2. How focused are you right now?

You will answer these questions using a simple self-rating scale from 1-5. After responding, you will be asked to think about why you chose that rating. This question is optional; however it promotes awareness of your abilities post-injury to recognize the need for strategies and assistance. You will see one of the following prompts after completing the self-rating:

  1. Consider the activity demands and your mental strengths and weaknesses.
  2. Consider distractions in your environment and distracting thoughts and feelings.

Next, you will be asked to select up to 3 strategies to use during this treatment to help you succeed. Implementing more than 3 strategies at a time would be overwhelming and likely ineffective, so choose them wisely. The strategies are not task-specific, and therefore can be applied to daily living tasks across many settings.

After completing the treatment, you will provide a follow-up rating to one of the following questions:

  1. How difficult was this treatment today?
  2. How focused are you right now?

You will compare your pre- and post-treatment rating. Take the time to think about and discuss the reason for any discrepancy.

Last, you will be asked to evaluate the strategies you chose so you can adapt your behavior to set yourself up for success:

  1. Did you use these strategies? Did they work?
  2. Would you do anything different next time?

FOR THE CLINICIAN: The metacognitive framework incorporates components of the predict-perform procedure and self-awareness training to enhance executive functioning. The goal is to maximize the patient's awareness, carryover the ability to implement strategies before starting a task (in or outside a structured therapeutic setting), and to self-assess performance after a task in order to adapt.


Selected References:

  1. Jeffay, E., Ponsford, J., Harnett, A., Janzen, S., Patsakos, E., Douglas, J., Kennedy, M., Kua, A., Teasell, R., Welch-West, P., Bayley, M., & Green, R. (2023). INCOG 2.0 guidelines for cognitive rehabilitation following traumatic brain injury, part III: Executive functions. Journal of Head Trauma Rehabilitation, 38(1), 52–64. https://doi.org/10.1097/htr.0000000000000834



Did this answer your question? Thanks for the feedback There was a problem submitting your feedback. Please try again later.