Cognitive Rehabilitation: an Integrative Neuropsychological Approach.

McKay Moore Sohlberg and Catherine A. Mateer The Guilford Press New York, NY 2001, 492 pages, $55.00

Cognitive Rehabilitation is the second book these authors developed to enhance professional understanding of neurological damage by emphasizing the neurological bases of contemporary cognitive rehabilitation services for persons who sustain brain injuries. Sohlberg and Mateer integrate their years of neuropsychological expertise and rehabilitation service delivery to provide interested professionals with a detailed understanding of neurological functioning and contemporary rehabilitation approaches.

The opportunity to review this book as a potential resource for rehabilitation counselors is an honor that I take quite seriously. Serving persons with brain injuries is a priority I have held all of my professional life. My impression of this book is based upon my professional experiences as a public vocational rehabilitation (VR) counselor, a private VR consultant, a vocational rehabilitation counselor at two comprehensive rehabilitation centers, a brain injury consultant who developed and provided community-based services for adults with brain injury, and my current role as a rehabilitation educator. At first glance, this book appeared to be a means for practicing rehabilitation counselors to expand their understanding of how the neurological bases of behavior play a core part in brain injury rehabilitation. The text is organized into four sections: fundamentals for practicing cognitive rehabilitation; management approaches for cognitive impairments; interventions for behavioral, emotional, and psychosocial concerns; and working with special populations. Highlights from these sections will be presented and their potential usefulness for rehabilitation counselors will be discussed.

The first section, entitled fundamentals for practicing cognitive rehabilitation, included the first four chapters of the text. Topics addressed included a historical review of cognitive rehabilitation, diagnostic instruments, demographic and injury related variables, and assessment concerns. The last section of this chapter, which discussed demographic and injury related variables of persons who sustain brain injury, was the portion most applicable to working with persons with brain injury. The relationship among these variables is information practitioners need to be aware of when serving this population. Other topics seemed appropriate, however the authors tendency to provide detailed reviews of the neurological literature to support their points was daunting.

The second section, management approaches for cognitive impairments, also evoked some mixed reactions for this reviewer. The chapters that focused on attention, memory, and management of executive dysfunction disorders were appropriate topics, but once again detailed reviews of the neurological literature detracted from the functional use of this section for rehabilitation counselors. However, the chapters focusing on external aids in cognitive rehabilitation, assessment and management of unawareness, and communications issues were quite applicable and useful. A combination of literature review and case studies provide brain injury professionals with a review of compensatory strategies and professional interventions that can be used when working with persons with brain injury.

Conversely, the section on interventions for behavioral, emotional, and psychosocial concerns was the most useful portion of the book. Topics including managing challenging behaviors, managing the environment, and working with families would be quite relevant for rehabilitation counselors specializing in serving persons with brain injuries. Professional strategies to limit impulsivity and social inappropriateness, and to shape the family environment included detailed information that may be translated into more appropriate service delivery. Research reviewed in this section and the case study discussions would be accessible to readers who do not have extensive neuropsychological/neuroscience training.

Finally, the section that addresses working with special populations provided timely information on the management of brain injuries acquired by adolescents and also management of mild brain injury. These topics are particularly important as evidenced by the societal focus on effective post-secondary transition of students with disabilities (many of whom have brain injury) and emerging evidence that "mild" brain injury may produce chronic pervasive residuals (such as decreased attention and concentration abilities, and diminished interpersonal skills) that negatively impact one's life.

Overall, Cognitive Rehabilitation focused on timely concerns that persons with brain injuries, service providers, and families face on a daily basis. Much of the enormous amount of information shared would be useful to rehabilitation counselors specializing in working with persons with brain injury. However, the several detailed neuropsychological literature reviews supporting the authors' points severely detract from the utility of this book for all rehabilitation counselors who want to upgrade their knowledge on persons with brain injury. Perhaps clinical psychologists, neuropsychologists, and/or neuroscientists would benefit more fully from this text. If these authors were to develop a book that focuses on functional applications of neurological dysfunction, without extensive discussion of neurological intricacies, I think that rehabilitation counselors and their consumers could benefit immensely.

Thomas D. Upton, Ph.D., CRC
Assistant Professor in Rehabilitation Counselor
Southern Illinois University
Carbondale, IL