Wilson BA, Gracey F, Evans JJ, Bateman A. Cambridge, UK: Cambridge University Press, 2009. Hardback: 380 pages, £55. ISBN-13: 9780521841498.
The field of rehabilitation for patients with acquired brain injury has grown substantially over recent decades. Despite a wealth of published material, few texts provide clinicians broad ranging assistance with the generation of ideas and practical guidelines for designing, undertaking and evaluating both individual and group-based programmes.
This book offers a unique and all-inclusive approach to explaining the underlying principles of neuropsychological rehabilitation for people with cognitive, emotional and behavioural difficulties, by integrating evidence-based treatment with clinical judgement and patient-centred goals. It is informative from a multi-disciplinary perspective, making it an essential asset for clinical psychologists, clinical neuropsychologists, speech and language therapists, occupational therapists, psychiatrists, neurologists, physiotherapists, social workers, nurses and other rehabilitation specialists.
There are four sections of the book, the first of which details a review of the background and theory of neuropsychological rehabilitation. This includes an overview of theories and models of cognitive and emotional functioning, behaviour, learning, assessment, recovery and compensation, all of which are synthesised into a comprehensive model.
With central focus on the patient and family, the model considers the impact of the person's premorbid personality, lifestyle, values and beliefs on the formulation of goals and expectations during the rehabilitation process, taking into account the nature, extent and severity of the brain injury. As such, the rehabilitation model involves assessment of discrepancies between ’pre-injury self-representations' and ’post-injury reality’, and the management of adverse reactions to post-injury changes to facilitate adaptive and realistic self-representations upon which to build in further stages of rehabilitation. It is largely in this context that the book lends itself to enhancing the likelihood of successful treatment outcomes, by supporting a shift away from traditional models that focused on programmes dictated by doctors and therapists, to more of a partnership between doctors, therapists and patients.
The second section of the book details guidelines for group interventions from cognitive, emotional, psychosocial and vocational points of view. These are aimed to equip patients with understanding the nature of their brain injury, awareness of cognitive problems, strategies to deal with these problems, management of emotional reactions to brain injury, and how to offer and receive psychological support to and from others. The roles and integration of families, carers and services in the rehabilitation process are covered, and a range of other pertinent skill-building groups are overviewed to progress patients in abilities of communication, independent living, leisure, vocation and study.
Several single case illustrations comprise the third section of the book, and exemplify how to apply and tailor the rehabilitation model to individual needs. The process begins with a thorough assessment of neuropsychological, psychological, language, physical, recreational and occupational functioning. For each case study, the book highlights how results of assessment can be incorporated into a rehabilitation plan which considers the patient's strengths, weaknesses and personal goals.
The fourth section of the book concludes with methods of evaluating the effectiveness of the rehabilitation programme.
Overall, this book is well written and flows in a step-by-step fashion. The content is particularly worthwhile for advancing experienced clinicians in their knowledge base, as well as for introducing less experienced clinicians to the field who are looking for a holistic approach to understanding and working with the population of acquired brain injury.
