NeuroRehabilitation - Volume 2, issue 1

Article Type: Other

DOI: 10.3233/NRE-1992-2101

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 4-4, 1992

Authors: Heinemann, Allen W.

Article Type: Introduction

DOI: 10.3233/NRE-1992-2102

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 6-6, 1992

Authors: Moore, Dennis

Article Type: Research Article

Abstract: Misuse of alcohol and other drugs negatively affects medical rehabilitation in several ways. Assessment of patients for substance abuse is a fundamental tool for addressing life-style and/or addiction-related risks for substance abuse. Assessments for substance abuse are most effective when they are individualized and prescriptive, sensitive both to the conditions that reinforce abusive behavior and the resources available for meaningful change. This article describes the theoretical perspectives most applicable to assessment within medical rehabilitation. Physical and psychological indices of substance abuse are reviewed and criteria for rating the severity of a problem are presented. Strategies for establishing substance dependence diagnoses …and subsequent health care billing are discussed. Intervention and treatment options are presented from the perspective of rehabilitation. Show more

DOI: 10.3233/NRE-1992-2103

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 7-15, 1992

Authors: Solomon, David | Sparadeo, Frank R.

Article Type: Research Article

Abstract: In the United States, traumatic brain injury is the leading cause of neurological disability. Head injury disrupts the structural and functional integrity of the brain and impairs cognition, including frontal lobe function. Alcohol, marijuana, and cocaine affect the central nervous system in a variety of ways. These drugs sometimes change the turnover and level of neurotransmitters, particularly acetylcholine, in a manner opposite to that of head injury. Although theoretically, such changes could represent a compensation for the effects of head injury, the available literature shows that substance use is harmful to the survivor of traumatic brain injury.

DOI: 10.3233/NRE-1992-2104

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 16-26, 1992

Authors: Jones, Gregory A.

Article Type: Research Article

Abstract: Substance abuse is a strong predisposing factor in the onset of traumatic brain injury and a significant postinjury problem. Appropriate approaches to substance abuse intervention and treatment for persons with brain injuries integrate substance abuse and brain injury rehabilitation techniques. This article reviews several modalities of substance abuse treatment and discusses their application in brain injury rehabilitation. An examination of a model treatment program using elements of these modalities is also included.

DOI: 10.3233/NRE-1992-2105

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 27-34, 1992

Authors: Kiley, Deborah J. | Heinemann, Allen W. | Doll, Matthew | Shade-Zeldow, Yvonne | Roth, Elliot | Yarkony, Gary

Article Type: Research Article

Abstract: Rehabilitation professionals were surveyed regarding their knowledge of substance abuse, attitudes regarding patients’ substance use, and referral practices for patients with substance abuse problems. A 47-item survey was completed by 1,211 professionals (37% response rate) after two follow-up attempts. Respondents suspected that 29% of their patients with traumatic injuries had substance abuse problems. Thirty percent reported that there was routine screening for alcohol and drug problems at their facilities. Fifty percent reported that substance abuse education was available for staff; 59% reported the presence of patient education regarding substance abuse. Although 79% reported that their facilities had referral procedures for …patients with substance abuse problems, only 44% reported making referrals. Patients were referred most often to Alcoholics Anonymous. The results suggest the need for education regarding substance abuse assessment and treatment, facility policies, and referral procedures. Show more

DOI: 10.3233/NRE-1992-2106

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 35-44, 1992

Authors: Krause, James S.

Article Type: Research Article

Abstract: Research suggests that as many as 50% of all spinal cord injuries are associated with alcohol intoxication. Despite this alarming figure, the issue of substance abuse is only now beginning to be addressed in rehabilitation settings. This article presents a model program that addresses substance abuse issues as part of the overall rehabilitation program after spinal cord injury. The program components include assessment, group therapy, individual therapy, alcohol-free and drug-free recreational outings, and in-house Alcoholics Anonymous meetings. The program’s development and philosophy, components, barriers to implementation, and new directions for the future are described.

DOI: 10.3233/NRE-1992-2107

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 45-51, 1992

Authors: Langley, Mervin J. | Kiley, Deborah J.

Article Type: Research Article

Abstract: Neurological disability appears to be associated with increased risk for substance abuse. Alcohol and other drugs, through their pharmacological or expectancy-based effects, provide unique coping functions for clients with neurocognitive deficits. In this article, risk factors are identified and a four stage model of prevention intervention is described. Cognitive-behavioral strategies are used to circumvent deficits in memory, insight, and impulse control. Clients learn a variety of coping behaviors and are assisted in developing a life-style that is incompatible with substance use.

DOI: 10.3233/NRE-1992-2108

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 52-64, 1992

Authors: Sparadeo, Frank R. | Strauss, David | Kapsalis, Kathleen Bradley

Article Type: Research Article

Abstract: There is clearly a significant relationship between substance use and brain injury. This relationship often begins at the time of brain injury and continues throughout rehabilitation to community reentry. Family adjustment to brain injury is complicated by the issue of substance use/abuse. Successful substance use/abuse intervention is greatly assisted by family involvement, which must begin at the time of injury with information regarding the role of substances in the occurrence of the injury. Continued involvement of the family through education is very helpful throughout the entire rehabilitation process. Unfortunately, family involvement is not always optimal; therefore, it is necessary for …the rehabilitation team to evaluate the family’s role in substance use interventions. In assisting the family to understand the role of substance use and the need for abstinence in rehabilitation, it is helpful to define the problem. This article discusses a differential categorization system that is divided into prevention and treatment dimensions. Categorization allows for the most efficient application of a wide range of interventions. Show more

DOI: 10.3233/NRE-1992-2109

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 65-73, 1992

Authors: Borden, William

Article Type: Research Article

Abstract: Neuropsychological sequelae to HIV infection may be complicated by a variety of cofactors, including a history of alcohol and substance abuse, head trauma, learning disabilities, and psychiatric illness. This article describes a brief treatment approach in psychotherapy of AIDS patients with mild to moderate cognitive impairment. A representative case study of a patient with AIDS-related cognitive impairment and a history of alcohol abuse shows how the use of life review in time-limited psychotherapy may help patients revise life structures in the context of illness experience and carry out psychological and social tasks in later stages of the condition. The narrative …approach described here complements other types of intervention in psychosocial rehabilitation and shifts the focus from disability and dysfunction to concern for existing strengths and personal growth. Emergent issues in clinical research are summarized. Show more

DOI: 10.3233/NRE-1992-2110

Citation: NeuroRehabilitation, vol. 2, no. 1, pp. 74-79, 1992