Abstract:
INTRODUCTION:The importance of structure in post-acute brain injury rehabilitation is repeatedly mentioned in clinical practice. However, there has been little exploration of the key elements of structure that promote greater levels of functioning and emotional/behavioural stability and how these elements are optimally integrated within the infrastructure of a rehabilitation service. OBJECTIVES:The nature of structure and why it is helpful is explored initially. Thereafter, the processes involved in transition from externally supported structure to the client 'self-structuring' are described. The infrastructure for facilitating these transitional processes are considered in terms of the design of services for systemic neurorehabilitation encompassing environmental factors (e.g. living environments, vocational and recreational options, step-up services and social milieus), therapeutic alliances (rehabilitation professionals, family, friends), organisational structures (service delivery, rehabilitation coaching, transdisciplinary teams) and rehabilitation philosophies and practice. CONCLUSION:It is concluded that the process of supporting individuals to transition from the 'structure' of the environment and other people towards self-structuring skills is a critical process in rehabilitation. This is reliant upon a comprehensive and robust organisational infrastructure that can successfully and flexibly integrate the core elements of structure across a transitional pathway towards increased independence and self-structuring.
journal_name
NeuroRehabilitationjournal_title
NeuroRehabilitationauthors
Jackson HF,Hague G,Daniels L,Aguilar R Jr,Carr D,Kenyon Wdoi
10.3233/NRE-141082subject
Has Abstractpub_date
2014-01-01 00:00:00pages
681-94issue
4eissn
1053-8135issn
1878-6448pii
Y116734G02N55368journal_volume
34pub_type
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