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The Changing Landscape of Holistic Brain Injury Rehabilitation

The rehabilitation process following traumatic brain injury (TBI) is a critical period of recovery from cognitive deficits, physical injuries, and other impairments that may occur as a result of injury. In recent decades, holistic rehabilitation programs developed a more thorough program that includes group therapy as well as individual and family education and cognitive rehabilitation. Such programs have improved social participation, vocational outcomes, functional skills, and psychosocial adaptation among many TBI patients.

Despite the positive impacts of holistic brain injury rehabilitation, very few programs remain given that insurance companies have changed their requirements for discipline-specific services. These new requirements, particularly ones limiting the number of sessions per discipline, essentially shut down most of the holistic brain injury rehabilitation programs across the United States.

Fortunately, researchers continue to investigate holistic neuropsychological rehabilitation and have discovered valuable information about its effectiveness. Over several decades, experts have found that a neuropsychologically informed process is necessary to improve long-term psychosocial and vocational outcomes, and in most cases, families of a TBI patient benefit from therapy and an education on their loved one’s specific impairments. Neuropsychology within rehabilitation programs has diminished in the absence of holistic rehabilitation practices; however, a review listed by the Association of Postdoctoral Programs in Clinical Neuropsychology revealed that 35% of pediatric fellowships and 43% of adult neuropsychology fellowships included rehabilitation training.

Other programs resembling holistic brain injury rehabilitation programs have been created with similar successes. For example, the Brain Injury Coping Skills group provides psychoeducational and cognitive behavioral intervention for TBI survivors and their families, and the Resource Facilitation program provides injury-specific education to help patients achieve their specific rehabilitation goals.

Although the availability of holistic brain injury rehabilitation programs has declined, many aspects of the programs have evolved and remain intact in rehabilitation programs across the country. Despite some negative outcomes that have occurred since the removal of many holistic rehabilitation programs, such as the significant shortening of rehabilitation time for most TBI patients, the neurorehabilitation field has continued to develop their practices to more closely resemble those of a holistic brain injury rehabilitation program.

Trexler L. The Changing Landscape of Holistic Brain Injury Rehabilitation. Brain Injury Professional. (February 2021).

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