Abnormal Psychology

Cognitive Disorders 699

is to write down any information that must be retrieved later, such as by making a

note about where in the parking lot the car is parked.

Depending on the patient’s abilities and inclinations, he or she may use a variety

of memory aids: diaries, notebooks, alarms, calendars, or hand-held electronic per-

sonal digital assistants (PDAs). A PDA-type device can be a very

effective memory aid because an alarm can be set to go off at

the appropriate time, and the device can display a text message

telling the patient what he or she needs to do at that moment

(“Take red pill now” or “Go to Dr. Gabi’s office at 23 Main

Street”) (Kapur, Glisky & Wilson, 2004). In contrast to memory

aids that require the patient to remember to use the tools (as in

remembering to look at written notes), PDAs do not require the

patient to remember as much information. Table 15.6 lists vari-

ous memory aids.

If a patient has not previously used such memory aids, how-

ever, he or she must be taught how to use them, which can create

a paradox: Even after learning how to use a memory aid, the

patient must later remember how to use it and then remember to

use it in the appropriate situation. Depending on the specifi c na-

ture of the memory problems, though, many patients can learn

new strategies and use them. To ensure that a patient has learned

a technique or strategy, the clinician should do the following

(Wilson, 2004):

• Explain the to-be-learned information as simply as possible.


• Ask the patient to remember only one piece of information or one proce-

dure at a time. For instance, a patient who had never used a PDA before,

such as Ms. A. in Case 15.3, should fi rst learn how to use the device to ac-

cess stored information (such as a grocery list) before learning how to enter

new information into it.

• Make sure that the patient understands the information—if the information

is verbal, he or she should paraphrase the information and repeat it back to

the clinician. For instance, after the clinician explained to Ms. A. how

to access information on the PDA, such as the grocery list, Ms. A. should

paraphrase those instructions.

• Link the new information to something the patient already knows. For

instance, the clinician could program the PDA so that pressing and hold-

ing the G key accesses the grocery list and pressing and holding the M key

accesses a medication schedule.

• Have the patient rehearse and practice the learned information frequently.

For example, Ms. A. should repeatedly access the grocery list while with the

clinician. Once she has mastered this step, she can proceed to learn how to

add information to the grocery list.

• Make sure that the patient is actively thinking about the information, not simply

parroting it.

Patients are more likely to remember their own actions than the corrections of

errors they make. Thus, mental health professionals may use errorless learning tech-

niquesto teach patients new information (Kessels & de Haan, 2003): Patients are ex-

plicitly guided in learning a new skill rather than being allowed to fi gure it out through

trial and error. For instance, if using errorless learning to teach Ms. A. how to enter a

grocery list into a PDA, the clinician would discourage guessing and give as much in-

formation as Ms. A. needed to enter the list correctly the fi rst time. If she didn’t know

what to do at a given step, the clinician would show her or provide help ranging from

very specifi c guidance (“Now press the green button”) to hints or prompts (“What do

you do fi rst to add an item?”), depending on her ability to take the next step correctly.

• Alarm clock for waking up


• Clock or watch to tell the date as well as the time


• Watch with a timer (for elapsed time)


• An appointment diary


• A journal (to write about and later read about events
  or experiences that otherwise would be forgotten)


• A notebook for writing notes to self


• Lists of things to do or buy, such as groceries


• Labels on cabinets and drawers


• Sticky notes with reminders about chores to be done


• A tape recorder for creating auditory notes to self


• Asking other people to provide reminders


• A PDA
  Source: Adapted from Wilson, 1999, p. 35, Table 3.4.

Table 15.6 • Memory Aids for People

With Memory Problems

Electronic devices can serve as memory aids for

patients with amnestic disorder. They can be pro-

grammed so that an alarm goes off at a particular

time, when the screen displays a message about

some action the patient should take.

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Errorless learning techniques

Techniques by which patients are explicitly

guided in learning a new skill rather than

being allowed to fi gure it out through trial

and error.