Geriatric and Seniors Therapists in Escondido, CA

Jean Sullivan
Psychologist, PhD
Verified Verified
Escondido, CA 92025
I conduct Medicare authorized tests of memory on a yearly basis for elderly clients.
I have been helping others improve their mental and emotional well-being for over 25 years. I enjoy working with all ages (infancy through adulthood and old age). I am equipped to handle severe mental illness and crises as well as difficult life transitions and stressful times. As a former Navy Psychologist I work exceptionally well in areas related to military service and traumatic stress and substance use disorders. I work in a collaborative way to find the most effective treatment for you. By the end of your first session, we have identified the problems to work on and a plan to help.
I conduct Medicare authorized tests of memory on a yearly basis for elderly clients.
I have been helping others improve their mental and emotional well-being for over 25 years. I enjoy working with all ages (infancy through adulthood and old age). I am equipped to handle severe mental illness and crises as well as difficult life transitions and stressful times. As a former Navy Psychologist I work exceptionally well in areas related to military service and traumatic stress and substance use disorders. I work in a collaborative way to find the most effective treatment for you. By the end of your first session, we have identified the problems to work on and a plan to help.
(858) 207-3856 View (858) 207-3856
Photo of Hilda Loza, LCSW, CBT, SEP, Clinical Social Work/Therapist
Hilda Loza
Clinical Social Work/Therapist, LCSW, CBT, SEP
Verified Verified
Escondido, CA 92025
I work with adults and older adults in the treatment of depression, grief and loss; trauma, anxiety, and the emotional distress caused by life’s transitions.
I offer psychotherapy to individuals who are faced with a variety of concerns. My role is to provide a therapeutic presence through a safe environment to promote healthy self-expression which is important to beginning life’s mind and body journey. Being bilingual and culturally sensitive, I am aware of the personal, relational, and spiritual needs of the individual. I nurture strengths and am committed to facilitating personal growth, no matter how small the step is to get there.
I work with adults and older adults in the treatment of depression, grief and loss; trauma, anxiety, and the emotional distress caused by life’s transitions.
I offer psychotherapy to individuals who are faced with a variety of concerns. My role is to provide a therapeutic presence through a safe environment to promote healthy self-expression which is important to beginning life’s mind and body journey. Being bilingual and culturally sensitive, I am aware of the personal, relational, and spiritual needs of the individual. I nurture strengths and am committed to facilitating personal growth, no matter how small the step is to get there.
(760) 546-9408 View (760) 546-9408
Photo of Rebecca Boon, LCSW, Clinical Social Work/Therapist
Rebecca Boon
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Escondido, CA 92026
I have experience providing individual and group services to adults and seniors in medical, behavioral health, and non-profit settings.
I will take an active, non-judgmental, and creative approach in treatment to support you in reaching your goals and sustaining meaningful growth, balance and change. In therapy, I prioritize strengths-based and client-centered approaches with respect for diverse backgrounds while offering humor, psychoeducation, and practical coping strategies to increase healthy behaviors, self-awareness, and self-compassion. I most often draw upon techniques and theories found in mindfulness, solution-focused therapy, art therapy, motivational interviewing, and cognitive-behavioral therapy.
I have experience providing individual and group services to adults and seniors in medical, behavioral health, and non-profit settings.
I will take an active, non-judgmental, and creative approach in treatment to support you in reaching your goals and sustaining meaningful growth, balance and change. In therapy, I prioritize strengths-based and client-centered approaches with respect for diverse backgrounds while offering humor, psychoeducation, and practical coping strategies to increase healthy behaviors, self-awareness, and self-compassion. I most often draw upon techniques and theories found in mindfulness, solution-focused therapy, art therapy, motivational interviewing, and cognitive-behavioral therapy.
(619) 558-5439 View (619) 558-5439
Photo of Kristine M Jacquin, PhD, Psychologist
Kristine M Jacquin
Psychologist, PhD
Verified Verified
Escondido, CA 92026  (Online Only)
My practice is focused on psychological assessments for people of all ages. A psychological assessment is helpful to determine what is causing problems for you. I specialize in neuropsychological assessments, which include evaluations for ADHD, learning disabilities, head injuries, etc. I also specialize in forensic assessments, which are used to make legal decisions. After many years of conducting psychotherapy, I am currently only doing assessments. For psychotherapy, I recommend Dr. Dara Goldyne, who also has a profile on Psychology Today.
My practice is focused on psychological assessments for people of all ages. A psychological assessment is helpful to determine what is causing problems for you. I specialize in neuropsychological assessments, which include evaluations for ADHD, learning disabilities, head injuries, etc. I also specialize in forensic assessments, which are used to make legal decisions. After many years of conducting psychotherapy, I am currently only doing assessments. For psychotherapy, I recommend Dr. Dara Goldyne, who also has a profile on Psychology Today.
(805) 601-8186 View (805) 601-8186
Photo of Tara Gehler, MA, LMFT, Marriage & Family Therapist
Tara Gehler
Marriage & Family Therapist, MA, LMFT
Verified Verified
Escondido, CA 92025
You may not feel it or believe it right now, but you truly are the expert in your own life. Are you a parent worried about your child, or stressed and overwhelmed in relationships, not feeling like yourself, juggling it all and trying to keep it together? I’m here to help. My professional experience is based on over 15 years of working with individuals and families suffering from anxiety, substance use, grief, loss, depression, and trauma. I’ve dedicated my life and career to helping people navigate strenuous life situations while showing them that there is hope and a solution for everything.
You may not feel it or believe it right now, but you truly are the expert in your own life. Are you a parent worried about your child, or stressed and overwhelmed in relationships, not feeling like yourself, juggling it all and trying to keep it together? I’m here to help. My professional experience is based on over 15 years of working with individuals and families suffering from anxiety, substance use, grief, loss, depression, and trauma. I’ve dedicated my life and career to helping people navigate strenuous life situations while showing them that there is hope and a solution for everything.
(760) 960-5990 View (760) 960-5990
Photo of Steven T Griggs, PhD, Psychologist
Steven T Griggs
Psychologist, PhD
Verified Verified
Escondido, CA 92025
I'm an informal, low-keyed warm fuzzy type. I deal directly with problems, using CBT, emphasizing support/non-judgment. I've completed 15 ebooks. The subjects are Assertiveness, How To Change Children's Behavior (Quickly), How to Assess and Treat ADHD (Children and Adults), Self Esteem, Why Relationships Fail, How to diagnose and Treat Anxiety, Anger Management, Types I and II,, Kids and Divorce, Child Visitation and Self-Esteem, How To Change Teenagers Behavior, The Psychology of Procrastination, The Psychology of Guilt, The Psychology of Forgiveness and Weight Loss (Free), The Psychology of All Addictions and How to Diagnose and Treat Mood Disorders.
I'm an informal, low-keyed warm fuzzy type. I deal directly with problems, using CBT, emphasizing support/non-judgment. I've completed 15 ebooks. The subjects are Assertiveness, How To Change Children's Behavior (Quickly), How to Assess and Treat ADHD (Children and Adults), Self Esteem, Why Relationships Fail, How to diagnose and Treat Anxiety, Anger Management, Types I and II,, Kids and Divorce, Child Visitation and Self-Esteem, How To Change Teenagers Behavior, The Psychology of Procrastination, The Psychology of Guilt, The Psychology of Forgiveness and Weight Loss (Free), The Psychology of All Addictions and How to Diagnose and Treat Mood Disorders.
(760) 746-8355 View (760) 746-8355
Photo of Katherine Leahy, PsyD, LMFT, Marriage & Family Therapist
Katherine Leahy
Marriage & Family Therapist, PsyD, LMFT
Verified Verified
Escondido, CA 92025  (Online Only)
I specialize in treating issues related to the various life cycle transitions of individuals and families, parenting and child behavioral issues, and families with mental illness by providing a systemic perspective that is non-judgmental and alerts clients to the possibility and potential of creating happier life experiences for themselves.
I specialize in treating issues related to the various life cycle transitions of individuals and families, parenting and child behavioral issues, and families with mental illness by providing a systemic perspective that is non-judgmental and alerts clients to the possibility and potential of creating happier life experiences for themselves.
(858) 223-1485 View (858) 223-1485
Photo of Summer Silva, PsyD, Psychologist
Summer Silva
Psychologist, PsyD
Verified Verified
Escondido, CA 92027  (Online Only)
I have extreme passion and enthusiasm for guiding clients through the journey of finding peace, balance, and happiness. My areas of focus: Trauma/Abuse/PTSD, Eating Disorders, Borderline PD. I am also fluent in American Sign Language and have a wealth of knowledge regarding the Deaf and CODA cultures. My specialty areas include: Substance Use/Chemical Dependency, Mindfulness and Meditation, Relationships and Communication, Behavior Modification, Depression, and Anxiety. Homeopathy and Flower Essence practitioner; a natural way to stimulate healing emotionally and physically. Non-local appointments available. I received my doctorate degree from the California School of Professional Psychology at Alliant International University in San Diego.
I have extreme passion and enthusiasm for guiding clients through the journey of finding peace, balance, and happiness. My areas of focus: Trauma/Abuse/PTSD, Eating Disorders, Borderline PD. I am also fluent in American Sign Language and have a wealth of knowledge regarding the Deaf and CODA cultures. My specialty areas include: Substance Use/Chemical Dependency, Mindfulness and Meditation, Relationships and Communication, Behavior Modification, Depression, and Anxiety. Homeopathy and Flower Essence practitioner; a natural way to stimulate healing emotionally and physically. Non-local appointments available. I received my doctorate degree from the California School of Professional Psychology at Alliant International University in San Diego.
(760) 237-8865 View (760) 237-8865
Photo of Jo A Henry, MA, LMFT, CADC-II, SYMBIS, Marriage & Family Therapist
Jo A Henry
Marriage & Family Therapist, MA, LMFT, CADC-II, SYMBIS
Verified Verified
2 Endorsed
Escondido, CA 92026
Women who struggle with depression, anxiety, PTSD, and many other emotionally draining conditions just wish they had someone to talk to who will listen without judgment. You may have experienced a traumatic break-up or even a trail of brokenness. You may have experienced child abuse, sexual abuse, neglect, or abandonment. You may have grown up with a family member with an addiction, watched parental violence, or had a partner with an addiction. At this point in your life you need assurance things can change, you want answers to why you ended up in the same relationships, and you need the coping skills needed to get past the past.
Women who struggle with depression, anxiety, PTSD, and many other emotionally draining conditions just wish they had someone to talk to who will listen without judgment. You may have experienced a traumatic break-up or even a trail of brokenness. You may have experienced child abuse, sexual abuse, neglect, or abandonment. You may have grown up with a family member with an addiction, watched parental violence, or had a partner with an addiction. At this point in your life you need assurance things can change, you want answers to why you ended up in the same relationships, and you need the coping skills needed to get past the past.
(760) 537-4810 View (760) 537-4810
Photo of M. Babette Kout, MS, LMFT, Marriage & Family Therapist
M. Babette Kout
Marriage & Family Therapist, MS, LMFT
Verified Verified
Escondido, CA 92026
People who struggle with Depression, Anxiety, PTSD, and many other emotionally painful conditions just wish they had someone to talk to. Multiple traumas often occur over time, often within an atmosphere of attachment disordered relationships, neglect, and/or abandonment. You may have experienced child abuse, sexual abuse, grief, and loss. You may have grown up with family addiction/ partner addiction. At this point in your life you want answers to why you end up in the same relationships, and you need assurance things can change.
People who struggle with Depression, Anxiety, PTSD, and many other emotionally painful conditions just wish they had someone to talk to. Multiple traumas often occur over time, often within an atmosphere of attachment disordered relationships, neglect, and/or abandonment. You may have experienced child abuse, sexual abuse, grief, and loss. You may have grown up with family addiction/ partner addiction. At this point in your life you want answers to why you end up in the same relationships, and you need assurance things can change.
(760) 463-9517 View (760) 463-9517
Photo of Andrea Conboy Therapybreathwork, LCSW, APHSW-C, Clinical Social Work/Therapist
Andrea Conboy Therapybreathwork
Clinical Social Work/Therapist, LCSW, APHSW-C
Verified Verified
1 Endorsed
Escondido, CA 92027  (Online Only)
Do you feel like you are sacrificing your own well-being as you help others? Have the demands of working as a helper, in a helping profession (during and post-pandemic), exceeded your resources of time and energy? Do you not only feel emotionally exhausted and burned out, but judged (by you or others) for it? Let me tell you: There is nothing wrong with you! You are having a natural response to the stress and exhaustion of being a helper!
Do you feel like you are sacrificing your own well-being as you help others? Have the demands of working as a helper, in a helping profession (during and post-pandemic), exceeded your resources of time and energy? Do you not only feel emotionally exhausted and burned out, but judged (by you or others) for it? Let me tell you: There is nothing wrong with you! You are having a natural response to the stress and exhaustion of being a helper!
(442) 232-4151 View (442) 232-4151
Photo of Dr. Alexis Olson, PhD, Psychologist
Dr. Alexis Olson
Psychologist, PhD
Verified Verified
Escondido, CA 92025
I'm a licensed clinical neuropsychologist. My professional background is with people rehabilitating from illness or injury, and with those facing declining health (as themselves or their caregivers) due to brain disease. Such conditions can affect individuals, as well as couples and families. Common goals include assessing or improving thinking skills and emotional resilience, while adapting to unexpected changes in physical/mental abilities. I work with you to clarify values and develop new cognitive and emotional skills that allow you to be resilient to injury, illness, stress, and discomfort.
I'm a licensed clinical neuropsychologist. My professional background is with people rehabilitating from illness or injury, and with those facing declining health (as themselves or their caregivers) due to brain disease. Such conditions can affect individuals, as well as couples and families. Common goals include assessing or improving thinking skills and emotional resilience, while adapting to unexpected changes in physical/mental abilities. I work with you to clarify values and develop new cognitive and emotional skills that allow you to be resilient to injury, illness, stress, and discomfort.
(858) 295-1174 View (858) 295-1174
Photo of Dean Leav - Men's Issues - Dr. Dean, PsyD, QME, Author, Psychologist
Men's Issues - Dr. Dean
Psychologist, PsyD, QME, Author
Verified Verified
Escondido, CA 92025
Welcome to my practice. I have been in practice since 2007 and have been featured on ABC, NBC, and KCAL as an expert psychologist. I work primarily with men who have hit “rock bottom” and would like help getting up. These men are often in crisis when we first meet. The issues I address are typically related to unhealthy sexual behaviors, infidelity, financial recklessness, gambling, drugs/alcohol, dishonesty/lying, and relational conflicts. My therapy approach is a combination of psychoanalytic, cognitive-behavioral, and the 12-Step recovery model. I also share insight from my own painful but redemptive recovery journey.
Welcome to my practice. I have been in practice since 2007 and have been featured on ABC, NBC, and KCAL as an expert psychologist. I work primarily with men who have hit “rock bottom” and would like help getting up. These men are often in crisis when we first meet. The issues I address are typically related to unhealthy sexual behaviors, infidelity, financial recklessness, gambling, drugs/alcohol, dishonesty/lying, and relational conflicts. My therapy approach is a combination of psychoanalytic, cognitive-behavioral, and the 12-Step recovery model. I also share insight from my own painful but redemptive recovery journey.
(442) 200-1729 View (442) 200-1729
Photo of Jan O Wagman, PhD, LMFT, CCTP, Marriage & Family Therapist
Jan O Wagman
Marriage & Family Therapist, PhD, LMFT, CCTP
Verified Verified
Escondido, CA 92025
When your life isn’t what you want it to be – Is less fulfilling and satisfying then it should be –– Might be burdened with sadness or depression -- I offer guidance, support and comfort in a safe healing environment that can help turn your life around. Help you discover how wondrous it is to find the emotional strength and freedom you need to recognize then pursue -- and finally realize your full potential
When your life isn’t what you want it to be – Is less fulfilling and satisfying then it should be –– Might be burdened with sadness or depression -- I offer guidance, support and comfort in a safe healing environment that can help turn your life around. Help you discover how wondrous it is to find the emotional strength and freedom you need to recognize then pursue -- and finally realize your full potential
(760) 652-3445 View (760) 652-3445
Photo of Kelly M. Kaitson, LCSW, Clinical Social Work/Therapist
Kelly M. Kaitson
Clinical Social Work/Therapist, LCSW
Verified Verified
1 Endorsed
Escondido, CA 92026
Now Accepting New Clients! Do you feel you are not the best version of yourself? Are you feeling confused, scared, disconnected and lost? I am here to help. If you are being triggered by emotions and behaviors and it's making other problems in your life worse, I hope you will consider contacting me today. Supporting you at this time is my sincere desire and I'm here to tell you that there can be change, success and growth to bring forward your best version. I will equip you with tools and support so you not only get by but actually thrive. I look forward to speaking with you!
Now Accepting New Clients! Do you feel you are not the best version of yourself? Are you feeling confused, scared, disconnected and lost? I am here to help. If you are being triggered by emotions and behaviors and it's making other problems in your life worse, I hope you will consider contacting me today. Supporting you at this time is my sincere desire and I'm here to tell you that there can be change, success and growth to bring forward your best version. I will equip you with tools and support so you not only get by but actually thrive. I look forward to speaking with you!
(760) 415-0085 View (760) 415-0085
Photo of Sarah Ray, PsyD, QME, Psychologist
Sarah Ray
Psychologist, PsyD, QME
Verified Verified
6 Endorsed
Escondido, CA 92025
Now more than ever, it seems that so many of us are facing circumstances that make life stressful, confusing, and painful at times. The purpose of our work together is to help you live a healthier, happier, and more meaningful life. Whether you want to be a happier person, to have better relationships, or to simply understand yourself better, I can help you achieve this. I combine support, insight, and direction to help you have the skills to better manage your life, and obtain greater peace and joy. There is no greater privilege than helping a person improve their life, and I appreciate the opportunity to help you!
Now more than ever, it seems that so many of us are facing circumstances that make life stressful, confusing, and painful at times. The purpose of our work together is to help you live a healthier, happier, and more meaningful life. Whether you want to be a happier person, to have better relationships, or to simply understand yourself better, I can help you achieve this. I combine support, insight, and direction to help you have the skills to better manage your life, and obtain greater peace and joy. There is no greater privilege than helping a person improve their life, and I appreciate the opportunity to help you!
(619) 378-4402 View (619) 378-4402
Photo of Elena De Salvo, LMFT, Marriage & Family Therapist
Elena De Salvo
Marriage & Family Therapist, LMFT
Verified Verified
Escondido, CA 92026
Hi! I'm here to help you have the life you want, as sometimes life becomes challenging, and adjusting to life changes isn't always easy. I am glad that you prioritize your needs by coming here for help. I am Licensed Marriage and Family Therapist. I began therapy practice during my MA Program at JFKU in CA. For over 8 years, I've worked in various settings, including not-for-profit mental health agencies and private practice. I believe that treatment is a collaborative approach.
Hi! I'm here to help you have the life you want, as sometimes life becomes challenging, and adjusting to life changes isn't always easy. I am glad that you prioritize your needs by coming here for help. I am Licensed Marriage and Family Therapist. I began therapy practice during my MA Program at JFKU in CA. For over 8 years, I've worked in various settings, including not-for-profit mental health agencies and private practice. I believe that treatment is a collaborative approach.
(925) 397-4804 View (925) 397-4804
Photo of Phillip Salas, LMFT, Marriage & Family Therapist
Phillip Salas
Marriage & Family Therapist, LMFT
Verified Verified
Escondido, CA 92025
As a compassionate psychotherapist, I specialize in helping individuals navigate the challenges of anxiety, OCD, and depression. My therapeutic approach is tailored to create a safe space for exploration and healing. Together, we can work towards managing symptoms, fostering resilience, and restoring a sense of well-being. Let's embark on this journey towards emotional wellness, building the tools you need to thrive.
As a compassionate psychotherapist, I specialize in helping individuals navigate the challenges of anxiety, OCD, and depression. My therapeutic approach is tailored to create a safe space for exploration and healing. Together, we can work towards managing symptoms, fostering resilience, and restoring a sense of well-being. Let's embark on this journey towards emotional wellness, building the tools you need to thrive.
(619) 768-5663 View (619) 768-5663

More Therapists Nearby

Photo of John Mingo, Psychologist
John Mingo
Psychologist
Verified Verified
1 Endorsed
San Diego, CA 92128  (Online Only)
I offer a genuine, straight-forward approach to psychotherapy. This approach includes identifying specific goals and the mastery of real-life coping skills: all with the support you deserve. Having 20 years of experience in the Rancho Bernardo/Rancho Santa Fe/Poway area, I have worked in clinic and hospital settings in addition to private practice. Age range of my clients: teenagers to older adults. I also offer families and individuals comprehensive assistance setting up an entire treatment team of professionals (psychologist, psychiatrist, etc.). You can start this life-changing process with a free phone consultation.
I offer a genuine, straight-forward approach to psychotherapy. This approach includes identifying specific goals and the mastery of real-life coping skills: all with the support you deserve. Having 20 years of experience in the Rancho Bernardo/Rancho Santa Fe/Poway area, I have worked in clinic and hospital settings in addition to private practice. Age range of my clients: teenagers to older adults. I also offer families and individuals comprehensive assistance setting up an entire treatment team of professionals (psychologist, psychiatrist, etc.). You can start this life-changing process with a free phone consultation.
(619) 780-2497 View (619) 780-2497
Photo of Regina McClure, PhD, Psychologist
Regina McClure
Psychologist, PhD
Verified Verified
1 Endorsed
San Marcos, CA 92078
Additionally, I have extensive experience assisting older adults and their families, and welcome those anticipating upcoming marriage, parenthood, stepfamily, or other life transition.
When we've lost touch with our truer self, life is just harder. If you're not as present and engaged in your life as you'd like, you may also find your body weighing in through symptoms such as anxiety, depression, and unhelpful patterns of behavior. Underlying such symptoms are often vital, "offline" parts of ourselves that a good therapeutic alliance can help you to identify, strengthen and expand. If you're experiencing a readiness to take your online search for a therapist to the next level, I offer a brief phone consultation to help determine goodness of fit.
Additionally, I have extensive experience assisting older adults and their families, and welcome those anticipating upcoming marriage, parenthood, stepfamily, or other life transition.
When we've lost touch with our truer self, life is just harder. If you're not as present and engaged in your life as you'd like, you may also find your body weighing in through symptoms such as anxiety, depression, and unhelpful patterns of behavior. Underlying such symptoms are often vital, "offline" parts of ourselves that a good therapeutic alliance can help you to identify, strengthen and expand. If you're experiencing a readiness to take your online search for a therapist to the next level, I offer a brief phone consultation to help determine goodness of fit.
(760) 477-0325 View (760) 477-0325
Geriatric and Seniors Therapists

Is one ever too old for mental health therapy?

Individuals of all ages can benefit from mental health therapy. Indeed, older adults in particular may benefit from the social and psychological support a therapist can provide; the topics that older adults address in therapy may simply differ from those of younger clients. Seniors should seek out a therapist who has experience working with older individuals and who is well-versed in addressing common concerns among elderly individuals, such as depression, anxiety, loneliness, dementia, and physical mobility challenges.

How can geriatric therapy improve the quality of life of aging individuals?

Therapy for aging adults can greatly improve quality of life by providing an opportunity for them to process difficult emotions related to end-of-life, navigate relational or caregiver challenges, and develop coping skills for common mental health conditions, like anxiety or depression. Subsequent reductions in negative emotions and mental health disorder symptoms can make day-to-day living much more manageable for aging adults and those that care for them. The ongoing relationship with a trusted therapist can also help seniors combat loneliness and provide a sense of structure for their routine.

How is counseling for elderly different from counseling for other age groups?

Many aspects of geriatric counseling are similar to counseling in younger age groups; in general, counseling offers an opportunity for clients to process difficult life events and develop coping skills they can use outside of the therapy session. However, therapists who specialize in working with elderly clients may place a special emphasis on specific topics, such as caregiver relationships and reducing loneliness. They may be specially equipped to deal with certain physical conditions or facilitate discussion surrounding end-of-life topics. Counseling for the elderly may also place a greater emphasis on social work-type topics to ensure that geriatric clients have access to necessary resources, such as food, a safe home environment, and healthcare.

Can geriatric counseling help people who suffer from dementia?

Counseling can be highly effective for aging adults with dementia. While some therapists specializing in dementia may work with clients solely on topics surrounding memory loss, they can also assist clients with conditions that may co-occur at old age, such as anxiety or depression. Counselors specializing in working with older adults can also offer an objective assessment of a client’s functioning or disease progression to caregivers, and they may be particularly knowledgeable about community resources that may benefit dementia clients and their families. Therapists specializing in dementia may also be trained in specialized forms of therapy for memory-loss|memory loss, such as Cognitive Stimulation Therapy (CST)—which can help mentally stimulate dementia clients to preserve cognitive functioning.