The evolution of the clinician-scientist model of neurological rehabilitation.
Over the past three or four decades two treatment technologies have been evolving in parallel, recently to some extent merging. The first of these technologies is behaviour analysis, with its emphasis on identification and manipulation of variables external to the individual as controlling agents. The second is neurological rehabilitation, with a characteristic focus of resources on recovery of function following neurological damage. The histories of both of these technologies are similar in that they emerged from basic laboratory research with non-human subjects, followed by extension of findings to research with humans, culminating in widespread formal application of results. The past 5 years have seen a convergence of behaviour analytic and neurological rehabilitation techniques resulting in major shifts in treatment service delivery systems. We briefly chronicle the emergence of these two technologies from their basic underpinnings through world-wide use. Further, discussion is provided describing our and others' experience with the combining of behaviour and neurological rehabilitation. Finally, we give an account of an innovative neurological rehabilitation service delivery system designed to deliver effective cost-efficient treatment in the patient's natural environment. Implicit in the design and implementation of this real-world model of rehabilitation is the combination of behavioural technology and neurological rehabilitation towards the achievement of functional outcomes which endure. Our purpose in the above is to provide an introduction to present use and future potential of behaviour analytic methodologies and technologies in rehabilitation.
Peters
M D
MD
Paradigm Health Corporation, Concord, CA 94520, USA.
McLean
A
A
D000553:Ambulatory Care / Q000191:economics / Q000639:trends; D000818:Animals; D001925:Brain Damage, Chronic / Q000534:rehabilitation*; D001930:Brain Injuries / Q000534:rehabilitation*; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics / Q000639:trends; D005544:Forecasting; D006801:Humans; D010347:Patient Care Planning / Q000191:economics / Q000639:trends; D010348:Patient Care Team / Q000191:economics / Q000639:trends*; D012106:Research