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Milieu-Based Neurorehabilitation at the Adult Day Hospital for Neurological Rehabilitation

  • Pamela S. Klonoff
  • David G. Lamb
  • Steven W. Henderson
  • Marie V. Reichert
  • Susan L. Tully
Part of the Critical Issues in Neuropsychology book series (CINP)

Abstract

The Adult Day Hospital for Neurological Rehabilitation (ADHNR) has been providing a milieu-based rehabilitation program for persons with acquired brain injury at the Barrow Neurological Institute in Phoenix, Arizona, since January 1986. The ADHNR program was initially implemented by George P. Prigatano, PhD and Pamela S. Klonoff, PhD, based on a similar program at Presbyterian Hospital in Oklahoma City that Dr. Prigatano directed from 1980 to 1985. The Neuropsychological Rehabilitation Program at Presbyterian Hospital in Oklahoma City was a milieu-based program that assisted patients in becoming aware and acceptant of the neuropsychological consequences of their injuries, improving their personal reactions to their injury, and obtaining employment commensurate with their abilities (Prigatano et al., 1986). Morning hours were devoted to the remediation of and compensation for changes in cognitive, personality, and physical functioning. As time passed, the program was modified to include a structured work experience in order to enhance the effects of therapy within a work setting. The program emphasized developing a good working alliance, not only with patients, but also with family members.

Keywords

Traumatic Brain Injury Rehabilitation Process Acquire Brain Injury Cognitive Remediation Community Outing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Ben-Yishay, Y., & Diller, L. (1993). Cognitive remediation in traumatic brain injury: Update and issues. Archives of Physical Medicine and Rehabilitation, 74, 204–213.PubMedGoogle Scholar
  2. Ben-Yishay, Y., & Prigatano, G. P. (1990). Cognitive remediation. In M. Rosenthal, E. R. Griffith, M. R. Bond, & J. D. Miller (Eds.), Rehabilitation of the adult and child with traumatic brain injury ( 2nd ed., pp. 393–409 ). Philadelphia: F.A. Davis Press.Google Scholar
  3. Goldstein, K. (1952). The effect of brain damage on the personality. Psychiatry, 15, 245–260.PubMedGoogle Scholar
  4. Klonoff, P. S. (1997). Individual and group psychotherapy in milieu oriented rehabilitation. Applied Neuropsychology, 4, 107–118.PubMedCrossRefGoogle Scholar
  5. Klonoff, P. S., & Lage, G. A. (1991). Narcissistic injury after traumatic brain injury. Journal of Head Trauma Rehabilitation, 6, 11–21.CrossRefGoogle Scholar
  6. Klonoff, P. S., & Lage, G. A. (1995). Suicide in traumatic brain-injured patients: Risk and prevention. Journal of Head Trauma Rehabilitation, 10, 16–24.CrossRefGoogle Scholar
  7. Klonoff, P S., O’Brien, K. E, Prigatano, G. E, Chiapello, D. A., & Cunningham, M. (1989). Cognitive retraining after traumatic brain injury and its role in facilitating awareness. Journal of Head Trauma Rehabilitation, 4, 37–45.CrossRefGoogle Scholar
  8. Klonoff, R. S., Lage, G. A., & Chiapello, D. A. (1993). Varieties of the catastrophic reaction to brain injury: A self-psychology perspective. Bulletin of the Menninger Clinic, 57, 227–241.PubMedGoogle Scholar
  9. Klonoff, P. S., Shepherd, J., & Lamb, D. G. (1994). Management of patients with traumatic brain injury. In C. N. Simkins (Ed.),Analysis, understanding, presentation of cases involving traumatic brain injury (pp. 107–124 ). Washington, DC: National Head Injury Foundation.Google Scholar
  10. Klonoff, P. S., Lamb, D. G., Chiapello, D. A., Kime, S. K., Shepherd, J., & Cunningham, M. (1996). Cognitive retraining in a milieu-oriented rehabilitation program. In M. E. Maruish & J. A. Moses (Eds.), Theoretical foundations of clinical neuropsychology for clinical practitioners (pp. 219–236 ). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
  11. Klonoff, P. S., Lamb, D. G., & Henderson, S. W. (1998). Productivity of patients with brain injuries up to 11 years post-discharge from milieu-based rehabilitation [Abstract]. Archives of Clinical Neuropsychology, 14, 151–152.CrossRefGoogle Scholar
  12. Klonoff, R S., Lamb, D. G., Henderson, S., & Shepherd, J. (1998). New considerations for assessing outcome after milieu-oriented rehabilitation. Archives of Physical Medicine and Rehabilitation, 79, 684–690.PubMedCrossRefGoogle Scholar
  13. Luria, A. R. (1963). Restoration of function after brain injury. NewYork: MacMillan.Google Scholar
  14. Luria, A. R. (1974). The working brain. London: Pengu in Press.Google Scholar
  15. Prigatano, G. P., Klonoff, P. S., O’Brien, K. P., Altman, I. M., Amin, K., Chiapello, D., Shepherd, J., Cunningham, M., & Mora, M. (1994). Productivity after neuropsychologically oriented milieu rehabilitation. Journal of Head Trauma Rehabilitation, 9, 91–102.CrossRefGoogle Scholar
  16. Prigatano, G. P., Fordyce, D. J., Zeiner, H. K., Rouche, J. R., Pepping, M., & Wood, B. C. (1986). Neuropsychological rehabilitation after traumatic brain injury. Baltimore: Johns Hopkins University Press.Google Scholar

Copyright information

© Springer Science+Business Media New York 2000

Authors and Affiliations

  • Pamela S. Klonoff
    • 1
  • David G. Lamb
    • 1
  • Steven W. Henderson
    • 1
  • Marie V. Reichert
    • 1
  • Susan L. Tully
    • 1
  1. 1.Adult Day Hospital for Neurological RehabilitationSt. Joseph’s Hospital and Medical Center/Barrow Neurological InstitutePhoenixUSA

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