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Current Challenges for Neuropsychological Rehabilitation
Brain Impairment, 7(2), 151-165
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Although we have come a long way in improving services for people with brain injury since modern rehabilitation began in World War I, there are still a number of challenges facing us at the beginning of the 21st century. This paper addresses six of them. First, we need to strengthen the link between basic cognitive neurosciences and rehabilitation as results from the former remain of limited use to those of us dealing with the practical problems faced by survivors of brain injury. Second, we need to ensure that findings from neuroimaging really benefit rehabilitation in more than just name. Third, we should collaborate more with the pharmaceutical industry in the expectation that a combination of drug and neuropsychological treatments will lead to better results than either treatment used alone. Fourth, we need to improve ways of evaluating rehabilitation, which will mean relinquishing dependence on traditional outcome measures that frequently fail to apprehend the real needs of patients and families. Fifth, we must learn to make more informed decisions when selecting treatments so that our choice of whether to attempt restoration of lost function or to teach compensatory strategies or to rely on environmental modifications is based on more than just intuition. Finally, we need to know how best to persuade health care purchasers to fund rehabilitation: how do we convince them that while rehabilitation is likely to be expensive initially, it will be cost effective in the long term?