Generalization of treatment: a multicontext approach to cognitive perceptual impairment in adults with brain injury.

Cognitive perceptual remedial approaches used by occupational therapists in the treatment of adults with brain injury have been criticized because of claims that the effects are not generalizable. Little information is available, however, that can guide the therapist in directly addressing the generalization process. This paper proposes a multicontext treatment approach that uses five components identified in the cognitive psychology literature as being critical to the process of generalization: (a) use of multiple environments, (b) identification of criteria for transfer, (c) metacognitive training, (d) emphasis on processing strategies, and (e) use of meaningful activities. A case report is used to illustrate this treatment approach.