Description
Neuropsychological rehabilitation has shown tremendous growth in the last few decades, largely based on clinical acumen and experience. More recently, there has been much ado about the need for evidence-based rehabilitation based on the best available scientific evidence to support the effectiveness of interventions. The emphasis on evidence-based rehabilitation is often interpreted as standing in opposition to clinical judgment, when in fact these are complementary aspects of care, with sound clinical judgment required to apply the appropriate principles and techniques of treatment to the individual with a neurological disability. In addition, evidence-based treatment must incorporate the client’s values, preferences and goals in the decision-making process in order to make the treatment accommodations that may ultimately determine the effectiveness of treatment.
The current volume by Barbara Wilson, Fergus Gracey, Jonathan Evans, Andrew Bateman and their colleagues is unique in the integration of scientific evidence, clinical judgment and patient-centred goals as the basis for neuropsychological rehabilitation. In discussing the evidence for the effectiveness of neuropsychological rehabilitation, the authors – who are all experienced clinicians as well as prolific researchers – emphasize that rehabilitation is an interactive process that requires the involvement of therapists, the person with a disability, and family, even extending to the person’s community as a basis of support and reinforcement. The principles and examples that are elaborated in this volume provide a framework for approaching the individual client through an appreciation of their unique combination of limitations and strengths, motivation, personality and resources. The effectiveness of rehabilitation is evaluated in terms of the ability of rehabilitation to assist the client in reaching his or her personal goals and the relevance of treatment to the person’s everyday functioning and quality of life, and these principles guide the planning and implementation of neuropsychological treatment.
It is most impressive that all of these principles and practices have been developed within an integrative treatment model at the Oliver Zangwill Centre for Neuropsychological Rehabilitation. This represents a major accomplishment, for at least two reasons. First, the Centre provides a therapeutic milieu that serves as a critical component of treatment. The therapeutic milieu establishes a sense of cohesion among clients and reinforces the relationship among clients and therapists, factors that are common to all forms of effective treatment and have a significant role in rehabilitation even when individual treatment techniques are based on specific, empirically based interventions. Second, the treatment provided at the Oliver Zangwill Centre fosters the integration of theory and practice, reflected in the use of learning theory, principles of cognitive re-organization, and goal planning as a method of organizing and evaluating client-oriented clinical activity.
Ultimately, the goal of rehabilitation is to assist people to lead meaningful, fulfilling lives. This is a tremendous undertaking, and one that cannot be accomplished without a true collaborative effort. This volume provides a window into the techniques, principles and values that make this effort possible, and how they translate into effective neuropsychological rehabilitation