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Opening Address: The practice of neuropsychological rehabilitation
Brain Impairment, 6(2), 117-118
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Overview: Wilson's (2002) provisional model of rehabilitation synthesised a number of different models that have influenced the field. The two basic assumptions are that neuropsychological rehabilitation is concerned with the amelioration of cognitive, social and emotional deficits caused by an insult to the brain and the main purposes of such rehabilitation are to enable people with disabilities to achieve their optimum level of well being, reduce the impact of their problems on everyday life and help them return to their own, most appropriate environments. From this it follows that no one model, theory or framework can deal with all the difficulties facing people with brain impairments. These often include multiple cognitive impairments as well as accompanying social, emotional and behavioural problems. Methods: In order to understand which parts of the synthesised model were most used by practising psychologists engaged in neuropsychological rehabilitation, a questionnaire was designed and sent to British and Australian psychologists. Results: Forty five people responded. Some of the main results are summarised. The most frequently used treatment approaches derived from models of cognitive behaviour therapy (67%), cognitive neuropsychological theory (37%) and behavioural models (24%). Psychodynamic models were only used by 3% of respondents. Most practitioners tried to reduce disabilities and handicaps rather than impairments. They made use of several strategies to do this, with the most frequent being compensatory techniques, making use of residual skills and restructuring the environment (between 90 and 100% using these). Restorative approaches and attempts at anatomical reorganisation were rarely used. Conclusions: Practising psychologists in rehabilitation use a range of theoretical models and approaches in their clinical work confirming the view that we need a broad theoretical base when dealing with the complex problems faced by people with brain injury. Abstract only published - Paper given at the Conference on Neuropsychological Rehabilitation, July 11-12, 2005, Galway Ireland.