As an occupational therapist who had just recently joined the wheelchair services, I felt lucky to receive a bursary to attend the PMG Conference 2017 in Cardiff. I found it extremely useful for increasing my product knowledge, and expanding my skill base around 24-hour postural management.
I took the option of writing a book review, and chose The Brain Injury Rehabilitation Workbook because of my personal interest in brain injury rehabilitation, and being aware of the complex needs of this client group who require specialised assessment for the provision of powered mobility.
The contents of the book evolved from the psychoeducational groups run for clients with acquired brain injuries at the Oliver Zangwill Centre for Neurorehabilitation in Cambridge. The multi-disciplinary editorial team, consisting of an occupational therapist, a neuropsychologist and a clinical psychologist, is promoting an holistic framework for supporting clients with brain injuries, to treat the cognitive, social, emotional and functional aspects of injury.
Firstly, the authors discuss the six core principles underpinning the material offered in the book:
1) Working in a therapeutic milieu that contributes to a positive working alliance between client and practitioner to provide maximum support in the process of rehabilitation
2) The setting of meaningful and functionally relevant goals that involve all activities required for social participation, and contribute to a sense of identity
3) Shared understanding among client, family and practitioner with team vision, values and goals
4) Providing psychological interventions to enable clients to engage in positive change and overcome specific issues
5) Utilising compensatory strategies and re-training, the two principal approaches in managing cognitive impairments
6) Involving families and care givers in the rehabilitation process
The second chapter focuses on brain anatomy and mechanisms of injuries. It gives a general overview of structural functions and interactions between systems, thus establishing a common foundation for practitioners without specific neuropsychological training. It explains the different biological and structural mechanisms behind injuries, and discusses the different stages of recovery.
The book then looks at the effects a brain injury can have on all areas of a person's life, including attention, memory, executive functions, communication, fatigue and mood. Each area has a dedicated, detailed chapter providing a theoretical model and additional neuroanatomical information. The reader is given hands-on advice on how to assess and measure client functioning, and each chapter reviews the main barriers to adequate functioning. The chapters conclud with illustrative case examples. A number of practical and client-friendly handouts, with examples of effective techniques for building skills and teaching compensatory strategies, are also provided.
The last two sections discuss identity change (how the client makes sense of what happened to him or her). The family and other social networks are regarded as core building stones of the formulation process as they directly inform meaningful goal-setting and functional activities.
The chapters on cognitive skills, emotions and other related areas help inform treatment choices, and explain the underlying biological mechanisms, while the chapters on identity change and working with families are particularly useful for any therapist who interacts with this client group and their immediate social network. Although the book is primarily aimed at therapists working in community neurorehabilitation teams, it would be a good resource for any practitioner working with this client group.
While the authors seem to suggest that, to achieve best outcomes, therapists should work across professional boundaries, the book draws attention to the importance of being aware of one's disciplinary limitations, emphasising the use of core skills to address clients' needs holistically.
I would recommend this book as a basic but clear introduction to the rehabilitation of clients with non-progressive neurological conditions. Its great strength is its thoroughness; the detail and depth of information is at the right level for its target audience.