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Book Forum: Treatment Perspectives   |    
Cognitive Rehabilitation: An Integrative Neuropsychological Approach
RUSSELL EISENMAN, PH.D.
Am J Psychiatry 2002;159:1454-a-1455. doi:10.1176/appi.ajp.159.8.1454-a
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Edinburg, Tex.

By McKay Moore Sohlberg and Catherine A. Mateer. New York, Guilford Publications, 2001, 492 pp., $55.00.

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This is an excellent book, providing insights into neuropsychology and into the cognitive rehabilitation of clients. The authors cover a great deal of information in their 15 chapters, which are organized into four parts. Part 1, Fundamentals for Practicing Cognitive Rehabilitation, includes much important information about neurological disorders. Part 2, Management Approaches for Cognitive Impairment, gives practical strategies for addressing such issues as memory theory applied to intervention, management of dysexecutive symptoms, and communication issues. Part 3, Interventions for Behavioral, Emotional, and Psychosocial Concerns, deals with managing depression, anxiety, challenging behaviors, and working with families. Part 4, Working With Special Populations, has two chapters: chapter 14, "Rehabilitation of Children With Acquired Cognitive Impairments," and chapter 15, "Management Strategies for Mild Traumatic Brain Injury." Anyone who wants to know about neuropsychology, cognitive impairment, brain damage, and the treatment of such will find this a very useful book.

A couple of valuable insights will be briefly mentioned. On page 235 the authors begin a discussion of a clinical model of executive functions involving neuroanatomy and cognitive-based theories. The authors show that executive functioning involves the person’s being able to deal successfully with such things as initiation and drive (starting behavior), response inhibition (stopping behavior), task persistence (maintaining behavior), organization (organizing actions and thoughts), generative thinking (creativity, fluency, cognitive flexibility), and awareness (monitoring and modifying one’s own behavior). It becomes apparent that impairment in executive functioning can seriously impair one’s ability to function in everyday life as well as more serious tasks, such as work.

Another excellent discussion starts on page 346, where the authors discuss caregiver communication strategies. These include selectively ignoring behavior, redirecting the person’s attention, providing choices, reducing expectations, backing off and trying again, speaking quietly and maintaining a neutral stance, identifying signs of the patient’s escalating distress, and active confrontation and power struggles. Although these applied techniques might seem obvious, they are not. Surely, one is inclined to forget or miss some of them, and by providing them in just over 2 pages, the authors do us a real service.

The book combines technical knowledge with insights into treatment strategies. It is an excellent book, dealing with topics that many mental health professionals have had limited training in or have not pursued, even though we might readily have to deal with a client whose problems stem from problems of neuropsychology. This book gives us an excellent understanding of a wide variety of issues related to cognitive rehabilitation of neuropsychology problems.

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