Visit 6

In Visit 6, survivors are introduced to their first combined internal and external strategies: active listening and verbal rehearsal for socializing. Active listening is a compensatory strategy used in MAAT to help reduce social avoidance due to cognitive difficulties. Active listening involves using basic interviewing methods, such as summarizing and clarifying what one heard, so that survivors can compensate for parts of conversation they may miss. It presents an opportunity to clarify and “verbally rehearse” the conversational point to register and encode that point. Verbal rehearsal also provides a strategy to help become re-engaged in previously avoided social activity. Three steps can be taken to aid with active listening skills: (1) review nonverbal behaviors and paralinguistic tone; (2) review summarization (when the listener repeats back a summary of what it is they believed they heard, thus rehearsing the message); and (3) review clarification to seek assurance that what was heard was the intended message. Further, fatigue management and sleep improvement are highlighted if relevant to the survivor, with the rationale of using simple behavior change to minimize the potential impact of sleep problems and fatigue on cognitive function.