This is the 2007 version. Click here for the 2017 chapter 14 table of contents.

Rehabilitation Counseling

An example of successful rehabilitation psychology is group therapy for open-heart surgery patients. Radical changes in diet and exercise programs may help prolong the life of individuals with heart problems. This requires a degree of behavioral change that is unlikely to take place without concentrated support. Sometimes a weekly group meeting is effective for promoting the needed changes.

How can a weekly group meeting help heart patients?

Head injuries can produce subtle psychological problems that go overlooked by doctors but which may be helped by psychological counseling. One study did a follow up of 424 people who suffered head injuries but were discharged as "neurologically normal" from the University of Virginia medical center after two days or less of hospitalization. Six months later, nearly 8 of 10 complained of headaches, 6 of 10 had memory problems, and a third had not returned to their former jobs. In addition, many complained of fatigue, difficulty concentrating, and a shortened attention span. Some patients with minor traumatic brain injuries (MTBI) experience depression after an accident. The effects can occur after any motion that shakes the brain inside the skull case "including an assault, sports injury, fall or physical abuse" (Rabasca, 1998).

What sorts of problems are produced by head injuries?

Dr. Thomas Boll, a neuropsychologist at the University of Alabama, found that "at least a third" of patients who had head injuries classified as minor suffered fairly severe aftereffects. Most of these people never lost consciousness after their injuries and were unaware that they would experience such disturbing aftereffects. Dr. Leonard Diller of the head trauma program at New York University's Institute of Rehabilitation Medicine said they were experiencing symptoms of "subtle brain damage":

...The person...sits around, loses track of things, interrupts things, has a short attention span, is unable to do his former job, has difficulty maintaining family relationships and sustaining old friendships, has trouble learning new things, develops sexual problems, or thinks of himself as worthless. (Brody, 1983)

How can counseling help people adjust to aftereffects of head injuries?

Dr. Diller added, "Fully half the families with these problems were told when the patient was discharged from the hospital that 'everything would be all right.'" Such patients and their families require a number of specialized counseling services from psychologists and related health professionals. Often the patients may have to be advised to stay away from alcohol. Cognitive therapies may be designed to improve their problem solving and planning abilities. Computer games can help restore eye hand coordination.

What is "re-maritalization"?

Stroke presents a special problem for families and spouses of recovering victims. Some strokes have minor effects that quickly disappear. Others can permanently change an individual's personality. That can be quite disturbing to family members. A person who was formerly strong and dominant may return from the hospital weak and docile. An individual who previously would never utter a curse world may "cuss like a sailor" after a stroke. A wife of a stroke victim spoke of the need for remaritalization —re-inventing a marriage—after a stroke changed the personality of her husband.

What problems do people with lupus sometimes face?

Rehabilitation counseling helps people revise their schedules and lifestyles when this is required by time-consuming, repetitive treatments like hemodialysis (the blood-cleansing procedure used in cases of kidney failure). It helps with marriage and family counseling when the symptoms of a disease have an impact on day to day life. For example, patients with systemic lupus erythematosus ("lupus") may benefit from counseling to help them cope with the symptoms of that disease, which can include mood changes, loss of energy, weakness, and hair loss.

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