Professional Documents
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Interventions For Self
Interventions For Self
Interventions For Self
CONCLUSION
Neuropsychological rehabilitation is continually evolving in both principle and practice due to a
growing body of research with ever-increasing methodological rigor, but a grand unifying theory
has yet to be developed. Similarly, a “one size fits all” treatment approach will likely remain
elusive and perhaps rightfully so. Each cognitive rehabilitation patient presents with a unique
combination of injuryrelated deficits, premorbid strengths and weaknesses, life goals, and
personal values and beliefs. Therefore, clinicians must stay current with the literature on
available interventions, evidence for efficacy, and outcomes as a function of patient
characteristics and must flexibly apply interventions with an understanding of the individual
needs and goals of the patient. Ylvisaker points out that there has been a paradigm shift from
more traditional approaches, the goal of which is to “fix” the cognitive problem, to more
contextualized approaches whose goal is to enable individuals to live a fuller life by reducing the
burden caused by the cognitive problems. Wilson stated that We have moved on from the early
days of cognitive rehabilitation with its emphasis on drills and exercises to try to reduce basic
impairments, to a more individualized approach addressing the everyday manifestations of these
impairments, i.e., disabilities and handicaps…Cognitive rehabilitation should focus on real-life,
functional problems, it should address associated problems such as mood and behavioral
problems in addition to the cognitive difficulties and it should involve the person with the brain
injury, relatives and others in the planning and implementation of cognitive rehabilitation. (pp.
98–99) Finding a balance between these two conceptualizations of cognitive rehabilitation
continues to present a challenge, and this challenge underlies the controversies of outcome
measurement, distinction between domain-specific training and generalization, and the apparent
contrast between restoration and compensation. Yet, these controversies continue to stimulate
new innovations by clinicians and researchers, whose work constitutes a quest to find better
ways to help TBI survivors improve their cognitive and emotional functioning in order to regain
their independence.