Sanman said:
I just finished reading the article and it certainly brings up many good points. I certainly do agree that neuropsychology as a discipline needs to work the treatment aspect of its work. That is, in part, why I am mostly interested in working with ADD and LD. They seem to allow for more treatment options as far as organizational and educational methods. Certainly I'm interested to see if biofeedback will work out and I would like to develop computer software and other technology for such populations. I also agree about putting patient care first and working toward real world applications of neuropsychology. Certainly, involving other professionals, such as therpists and educational/vocational counselors, would benfit patients who are less concerned with the minutia of their diagnosis and just want to get on with their lives. It also makes for a better business. Patients are more willing to shell out cash, even if insurance doesn't, to have tests that can help them with their lives in some way than just for the sake of diagnoses. It also brings up the issue of whether private practice in neuropsych is going to be viable in the future. Certainly that is a seperate issue altogether and one that deserves in depth discussion for any future neuropsychologist.
Hi, Sanman.
The August issue of the
American Journal of Geriatric Psychiatry features a number articles from the field of geriatric neuropsychology. Here's a link to the issue:
http://ajgp.psychiatryonline.org/current.shtml
Palmer's article "The Expanding Role of Neuropsychology in Geriatric Psychiatry" provides a historical review and current perspective regarding the role of geriatric neuropsychology in geriatric psychiatric practice.
The article by Lowenstein et al. titled "Cognitive Rehabilitation of Mildly Impaired Alzheimer Disease Patients on Cholinesterase Inhibitors" is a step toward identifying a cognitive rehabilitation package for AD -- definitely the type of research the field needs.
Other recent articles on cognitive rehabilitation that are worth checking out:
Arch Phys Med Rehabil. 2004 Jun;85(6):943-50.
Community integration and satisfaction with functioning after intensive cognitive rehabilitation for traumatic brain injury.
Cicerone KD, Mott T, Azulay J, Friel JC.
Cognitive Rehabilitation Department, JFK-Johnson Rehabilitation Institute, 2048 Oak Tree Road, Edison, NJ 08820, USA.
[email protected]
OBJECTIVE: To evaluate the effectiveness of an intensive cognitive rehabilitation program (ICRP) compared with standard neurorehabilitation (SRP) for persons with traumatic brain injury (TBI). DESIGN: Nonrandomized controlled intervention trial. SETTING: Community-based, postacute outpatient brain injury rehabilitation program. PARTICIPANTS: Fifty-six persons with TBI. INTERVENTIONS: Participants in ICRP (n=27) received an intensive, highly structured program of integrated cognitive and psychosocial interventions based on principles of holistic neuropsychologic rehabilitation. Participants in SRP (n=29) received comprehensive neurorehabilitation consisting primarily of physical therapy, occupational therapy, speech therapy, and neuropsychologic treatment. Duration of treatment was approximately 4 months for both interventions. MAIN OUTCOME MEASURES: Community Integration Questionnaire (CIQ); and Quality of Community Integration Questionnaire assessing satisfaction with community functioning and satisfaction with cognitive functioning. Neuropsychologic functioning was evaluated for the ICRP participants. RESULTS: Both groups showed significant improvement on the CIQ, with the ICRP group exhibiting a significant treatment effect compared with the SRP group. Analysis of clinically significant improvement indicated that ICRP participants were over twice as likely to show clinical benefit on the CIQ (odds ratio=2.41; 95% confidence interval, 0.8-7.2). ICRP participants showed significant improvement in overall neuropsychologic functioning; participants with clinically significant improvement on the CIQ also showed greater improvement of neuropsychologic functioning. Satisfaction with community functioning was not related to community integration after treatment. Satisfaction with cognitive functioning made a significant contribution to posttreatment community integration; this finding may reflect the mediating effects of perceived self-efficacy on functional outcome. CONCLUSIONS: Intensive, holistic, cognitive rehabilitation is an effective form of rehabilitation, particularly for persons with TBI who have previously been unable to resume community functioning. Perceived self-efficacy may have significant impact on functional outcomes after TBI rehabilitation. Measures of social participation and subjective well-being appear to represent distinct and separable rehabilitation outcomes after TBI.
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J Head Trauma Rehabil. 2004 May-Jun;19(3):266-76.
Collaboration between cognitive science and cognitive rehabilitation: a call for action.
Powell JM, Hunt E, Pepping M.
The Department of Rehabilitation Medicine, University of Washington School of Medicine, 1959 NE Pacific Street, Seattle, WA 98195, USA.
[email protected]
The fields of cognitive science and cognitive rehabilitation share a fundamental interest in the nature of cognition. Both groups address questions that are critical to our understanding of human thought. Researchers in basic cognitive science address these questions from a theoretical perspective. Clinicians in cognitive rehabilitation address them from an applied perspective for individuals with brain injuries. Collaborative efforts and cross-fertilization of theory and practice have been less than what might be expected given the underlying commonality of the two fields. Here, we explore the complex nature of the relationship between cognitive rehabilitation and cognitive science, discuss barriers to collaboration, and suggest ways of overcoming those barriers.
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