Brain Injury and Neuropsychological Rehabilitation: International Perspectives

By Anne-Lise Christensen; Barbara P. Uzzell | Go to book overview

CHAPTER TWENTY
Visions for Rehabilitation

Anne-Lise Christensen


ABSTRACT

Visions and plans for neuropsychological rehabilitation were developed initially on the basis of experiences in neurology and neurosurgery and in psychiatry. However, the most important experiences stem from work in an intensive outpatient program affiliated with the Psychology Department at the University of Copenhagen. Areas of concern for further development in neuropsychological rehabilitation are: (a) the concept of brain injury and its sequelae, (b) the methods selected for treatment, (c) professional areas necessary to provide the most effective treatment, (d) the initiation and duration of treatment, (e) the plan for effective rehabilitation, and (f) the outcome hoped or expected given the optimal conditions for treatment.

Until the last 20-25 years, brain injury and its sequelae have been in the hands of the medical profession. Damages to the brain have been treated neuromedically and neurosurgically with increasing success, increasing the survival rate after brain injury. The prospects for survivors have been discouraging largely due to early neurophysiology, where, in particular, Nobel Prize winner Cajal ( 1928) stated that dead brain cells do not regenerate. The subsequent negative conclusion that rehabilitation of an injured brain is impossible has had a very lasting, pernicious influence. Goldstein's ( 1973) important contributions to the early understanding of the mental sequelae was also influenced by this notion. It was his view that the most effective

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