Alternate Therapies in the Treatment of Brain Injury and Neurobehavioral Disorders: A Practical Guide.

Alternate Therapies in the Treatment of Brain Injury and Neurobehavioral Disorders: A Practical Guide Murrey GJ, ed. Binghamton, NY 13904, Haworth Press, 2006, paperback, 191 pp, illus, ISBN: 0-7890-2135-8, $24.95.

This book focuses on therapies for people with brain injury who have neurobehavioral disorders. The intent of the book is to improve the long-term outcomes for this patient population. Eight authors, along with the editor, contributed to this book. The editor is a clinical neuropsychologist who has directed the rehabilitation program at the Minnesota Neurorehabilitation Hospital in Brainerd, Minnesota.

The first chapter provides an introduction and overview of executive dysfunction in brain injury. Horticulture therapy, art therapy, music therapy, melodic intonation therapy, recreational therapy, chemical-dependency treatment, electroencephalograph (EEG) feedback, and craniosacral therapy are each given a chapter, resulting in a total of 9 chapters. These therapies are considered alternate therapies (not alternative), which are defined by the editor as nontraditional interventions and therapies.

The chapters follow a fairly consistent format. Each chapter provides an explanation of that particular intervention or therapy and its benefits for people with brain injury. Each chapter also includes the intervention or therapy goals. Case examples then are used to show how each specific intervention or therapy has an impact on this patient population. Educational requirements and training or academic programs are listed. Resources, contact information, and references are included at the end of each chapter.

This book has several problems. People-first language is not used throughout this book. The editor's definition of alternate therapies is confusing; in addition, it is not clear why recreation therapy is included as an "alternate" therapy. Recreation therapy is considered a standard therapy in many inpatient rehabilitation centers, as indicated by the American Therapeutic Recreation Association. Melodic intonation therapy is part of the training for a speech-language pathologist and is not a separate therapy. This intervention has been used primarily for people with aphasia.

Information about executive function deficits is repeated in many of the chapters, especially in the chapter on treatment for chemical dependency. Discussion about the structure and level of difficulty of tasks could have been expanded in the first chapter and, therefore, could have been omitted in the remaining chapters.

The goals listed are not measurable and not necessarily specific to people with brain injury, as noted in the chapter on horticulture therapy. The case examples are not always specific to people with brain injury, and the case example in the chapter on craniosacral therapy does not discuss the patient outcome specific to this therapy. The educational requirements, training or academic programs, resources, and contact information may soon become out of date. Many of the references are old, and the author of the EEG feedback chapter provides many references to her own work.

This book provides an introduction to these interventions and therapies in one compilation, although much of this information can be found on each association's Web site. Certification, training, or education is needed to provide many of the included interventions or therapies. This book may be beneficial for rehabilitation professionals to raise their awareness of what interventions or therapies may be available for people with brain injury or neurobehavioral disorders--after the completion of a traditional rehabilitation program.

Marianne R Orest, PT

Fletcher Allen Health Care 

Medical Center Campus

Burlington, Vt

Orest is Clinical Research Educator and treats patients, facilitates quality improvement projects, and performs clinical research in a tertiary care facility. She is also Adjunct Clinical Assistant Professor at the University of Vermont, where she is involved in the spinal cord injury, traumatic brain injury, and stroke sections of the curriculum.