Cognitive Rehabilitation for Persons with Traumatic Brain Injury: A Functional Approach.

Cognitive Rehabilitation for Per. sons with Traumatic Brain injury: A Functional Approach Kreutzer JS, Wehman PH, eds. Baltimore, MD 21285-0624, Paul H Brookes Publishing Co, 1991, hardback, 299 pp, $48.

The editors state that "this book is intended to provide practical information about cognitive rehabilitation." This ambition is accomplished well, in that a broad spectrum of clinically relevant issues is covered within the 20 chapters. A strong core of experts, predominantly psychologists and speech pathologists, have been collected as chapter authors to paint a broad-brush overview of cognitive rehabilitation practice considerations from the perspective of a formalized and distinct treatment model. The chapters are organized around four topic sections: (1) "Foundations of Cognitive Rehabilitation," providing a background in cognitive theory, research challenges, and professional education issues; (2)

Personality, Behavior, Outcome, and Holistic Intervention," exploring outcome measurement strategies, cognitive processing theories, pharmacology, and psychosocial issues; (3) "Interdisciplinary Approaches to Cognitive Rehabilitation," outlining specific treatment topics, such as awareness training and compensation, memory retraining, microcomputer applications, and issues unique to pediatric clients; and (4) "Rehabilitation in Community Settings," discussing various aspects of home and community treatment methods. Each contributing author adheres to a common format that links the chapters: introductory comments, a statement of purpose, presentation of information and supportive data, a conclusion statement, and an extensive reference list. Each chapter, however, was obviously written independently and would be able to stand alone in monograph form. This style offers easy reference to select topics that are covered in toto within each chapter, but challenges the reader's patience with reiterations of the same demographic statistics at the head of nearly every chapter. Perhaps an introductory chapter presenting this background information as a singular topic would avoid the perceived need for such redundancy throughout the book. The overview style of the book, though somewhat superficial, allows a rich and unique variety of theoretical and practical issues to be raised within one cover. An entire chapter, 'for instance' is devoted to issues related to continuing professional education needs within cognitive rehabilitation programs. The reader may pay for this breadth of coverage with the need to refer to secondary sources for further background or explanatory information, particularly in the theoretical areas. The use of graphic support is rather sparse, generally presented in the form of data tables, but is appropriate for the book's content and style. From a final editing standpoint, a few typographical errors keep the reader alert. At least one typo was rather humorous, transforming "an individual who is highly distractible. . . into "an individual who is highly destructible...[sup.(p89)] The only serious criticism of this book involves the omission of discussion pertaining to the application of principles outside the formal cognitive retraining session. The editors explicitly state in the preface that "we know that cognitive rehabilitation requires interdisciplinary involvement and teamwork," and they devote an entire section to the topic of interdisciplinary treatment issues. From cover to cover, however, cognitive rehabilitation is presented as an independent modality that is somehow set aside from the general treatment milieu. Interdisciplinary issues are omitted entirely, and physical therapy implications are uniformly overlooked by chapter authors. The concept of "interdisciplinary" cognitive treatment is confined to incorporating family involvement in the psychologist's or speech pathologist's treatment session. Despite this overt limitation, the diverse information presented will allow astute physical therapists working with clients who have undergone brain injury to distill useful ideas for incorporation into their treatment planning. The information is also useful for physical therapists wishing to gain a better appreciation for the challenges faced by treatment team members dealing directly with cognitive rehabilitation. The level of writing is appropriate for physical therapists who have some clinical experience in the area of brain injury rehabilitation.

Mark R Eliason, PT St Joseph's Hospital and Medical Center Phoenix, Ariz