title: Structure to self-structuring: infrastructures and processes in neurobehavioural rehabilitation.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Transitional Rehabilitation Units, Haydock, UK.
authors.forename: Howard F
authors.initials: HF
authors.lastname: Jackson
authors.affiliation: The Transitional Rehabilitation Units, Haydock, UK.
authors.forename: Gemma
authors.initials: G
authors.lastname: Hague
authors.affiliation: The Transitional Rehabilitation Units, Haydock, UK.
authors.forename: Leanne
authors.initials: L
authors.lastname: Daniels
authors.affiliation: The Transitional Rehabilitation Units, Haydock, UK.
authors.forename: Ralph
authors.initials: R
authors.lastname: Aguilar
authors.affiliation: The Transitional Rehabilitation Units, Haydock, UK.
authors.forename: Darren
authors.initials: D
authors.lastname: Carr
authors.affiliation: The Transitional Rehabilitation Units, Haydock, UK.
authors.forename: William
authors.initials: W
authors.lastname: Kenyon
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D001930:Brain Injuries / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy; D019091:Critical Pathways / Q000458:organization & administration; D056344:Executive Function; D005190:Family; D006801:Humans; D009483:Neuropsychological Tests; D012054:Reinforcement, Psychology; D012146:Rest; D012648:Self Care / Q000523:psychology; D020377:Self Efficacy; D012931:Social Environment