The Relationship Between Patient Readiness and Cognitive Rehabilitation Intervention

Traumatic brain injury (TBI) is a principal cause of death and disability in young adults with consequences ranging from physical disabilities to long-term cognitive, behavioral, and social disorders (Salazar, Warden, Schwab, Spector, Braverman,

Rosner, Martin, & Ecklund, 2000). For these reasons, the total cost of TBI in the United States is estimated at more than $37 billion per year. Postacute TBI management differs significantly from that of other neurological disabilities. Most TBI patients appear to benefit from some level of specialized, interdisciplinary rehabilitation. However, as Salazar, et al. (2000) have noted, cognitive rehabilitation strategies for TBI have not been subjected to the degree of scientific scrutiny for effectiveness and cost efficiency that is expected of other medical therapies.

Despite the lack of a comprehensive database of empirical

support for the efficacy of cognitive rehabilitation and differing therapies used with patients affected by TBI, the literature on the topic, is extensive (Jordan, 2000). The efficacy of cognitive rehabilitation in the treatment of patients with TBI has been a controversial issue.

Jordan (2000) has stated that in the current era of evidence-based medicine and increased scientific scrutiny of common medical practices, the efficacy of therapeutic intervention needs to be supporte

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ority of such injuries are classified as mild in terms of severity. Many individuals who suffer from mild TBI still experience impairments in cognitive and psychological functioning that can impede employment, resulting in decreased performance and frequent job changes. Where medicine leaves off in the treatment of TBI, cognitive rehabilitation begins. Boake and Boake (1991) indicate that because of the long recovery course after TBI, many patients are appropriate for postacute rehabilitation treatment or therapy directed at community re-entry and a return to work. Newer program models for patients with TBI, particularly programs employing cognitive rehabilitation techniques or strategies, are controversial because of inadequate research support and uncertain cost effectiveness (Boake and Boake, 1991). Cognitive rehabilitation is a term used to refer to that branch of rehabilitation aimed at patients who are disabled primarily as a result of impairments in memory, judgment, and other cognitive functions. Recent editorials in various publications have suggested that there is a very real divergence of opinion among experts in the field of neurologic rehabilitation (Berrol, 1990; Levin, 1990; Volpe & McDowell, 1990). ASHA
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Approximate Word count = 9092
Approximate Pages = 36 (250 words per page)