Relatives as lay-therapists for the severely head-injured

Although the need for an integrated approach to the management of the head-injured patient has been recognized, and the concept of incorporating the family in the rehabilitation treatment programme suggested, there is minimal documentation of how the services of family members can be utilized to optimal effect. At a large university teaching hospital in Sydney, Australia, an early intensive rehabilitation programme was pretested on 37 patients during 1984-85. The pretest was to identify the extent to which relatives could contribute input as lay-therapists to such a programme. The findings indicate that relatives can make a major time commitment to providing therapy, but that to avoid harm to both patients and relatives certain safeguards need to be enforced. These experiences and resultant recommendations may have a bearing on the organization of rehabilitation programmes for other categories of patient.