Clinical reasoning in cognitive rehabilitation therapy

Many who provide cognitive rehabilitation therapy (CRT) are unaware of the theoretical rationale that underlies their decisions concerning therapeutic intervention. Can the survivor form goals for treatment? When should treatment end? When should the therapist retrain skills, provide remedial cognitive treatments, or simply adapt surroundings because a survivor is too handicapped to be treated at all?

This paper combines theory with the author's experience to provide therapists with a structure for clinical reasoning in their daily practice.

The discussion begins with a description of different models of recovery after brain injury. It goes on to discuss similarities, commonalities, and general principles that can be derived from all of them. It ends with suggestions for treatment that serve as useful guidelines for therapists in their practices.

Combining the clinician's clinical intuition with knowledge of the theory of CRT can greatly improve the quality of treatment the therapist provides.