Evidence suggests that the format of therapist-guided rehabilitation is able to harness some of the well-established benefits of the therapeutic relationship, and may be preferable to computer-guided training ( Cooper et al., 2017). Some of the most promising results to date have been demonstrated for training of attention and working memory, which have been shown to correspond to changes in functional brain activity ( Kim et al., 2009).

Restorative cognitive training approaches have been shown to improve cognitive functioning across multiple conditions such as schizophrenia, traumatic brain injury, and normal aging ( Ball, Edwards, & Ross, 2007 Fisher, Holland, Merzenich, & Vinogradov, 2009 Lebowitz, Dams-O’Connor, & Cantor, 2012 Lovell & Solomon, 2011 Smith et al., 2009). ‘Cognitive’ methods of rehabilitation are focused on improving performance on individual cognitive tasks, with the hope that these gains will generalize to functional activities ( Cicerone, 2002 Giles, 2010). Previously-validated rehabilitation approaches for TBI include both ‘cognitive’ and ‘functional’ approaches. Rehabilitation has been shown to improve outcomes for those experiencing chronic effects of TBI ( Cicerone, 2002 Cicerone et al., 2011 Cooper et al., 2017 Kennedy et al., 2008 Rohling, Faust, Beverly, & Demakis, 2009). As many as 3.2–5.3 million people in the US are living with TBI-related disability ( Selassie et al., 2008). For example, challenges in attention and concentration could result in distractibility and errors in work settings, and deficits in executive functions could lead to poor organization and problems with setting and achieving occupational goals. Studies conducted across a wide range of neurological and psychiatric conditions show that neuropsychological abilities are strongly associated with functional skills and employment outcomes ( Andelic, Stevens, Sigurdardottir, Arango-Lasprilla, & Roe, 2012 Dawson, Schwartz, Winocur, & Stuss, 2007 Drake, Gray, Yoder, Pramuka, & Llewellyn, 2000 Kalechstein, Newton, & van Gorp, 2003 Leahy & Lam, 1998 Wehman, Targett, West, & Kregel, 2005). These TBI-related impairments can have significant life consequences.

TBI can affect a wide range of brain systems, resulting in sensorimotor deficits (e.g., coordination, visual perception), cognitive deficits (e.g., memory, attention), emotional dysregulation (e.g., irritability, depression), and somatic symptoms (e.g., headache, fatigue) ( Ponsford et al., 2014). Each year, emergency departments treat approximately 2.5 million traumatic brain injuries (TBIs) ( Langlois, Rutland-Brown, & Thomas, 2006 Marin, Weaver, Yealy, & Mannix, 2014).

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