The psychological, political, and economic realities of brain injury rehabilitation in the 1990s.
Gans, in 1983, detailed the prevalence, causes, and implications of hate in the rehabilitation setting, and offered suggestions for therapeutic responses to it. Mullins, in 1989, noted that during the 1980s rehabilitation became a rapidly expanding, increasingly privatized, big business, with seemingly limitless opportunities for advancement and profit. He asserted that during those years hate had been joined by power, envy and greed in the rehabilitation setting. The present article builds upon the two earlier ones and reviews recent events and their effects, including: the continued development of rehabilitation as a business, the national economic slow down, the health-care crisis, the rise of managed care, the fear that rehabilitation workers feel for their jobs, and the loss of control that people feel throughout rehabilitation. Suggestions for improving the current situation are offered to clinicians, administrators, insurers, and educators, and all are urged to do what they know is right.
Leri
J E
JE
Erie Psychology Consortium, PA 16507, USA.
D001925:Brain Damage, Chronic / Q000191:economics / Q000534:rehabilitation*; D001930:Brain Injuries / Q000191:economics / Q000523:psychology / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis / Q000639:trends; D004992:Ethics, Medical; D005544:Forecasting; D006801:Humans; D008329:Managed Care Programs / Q000191:economics*; D010348:Patient Care Team / Q000191:economics; D011057:Politics; D011332:Privatization / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics; D012047:Rehabilitation Centers / Q000191:economics*; D014481:United States