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A Pilot Study of Neuropsychological Rehabilitation

Department of Psychiatry, University of Colorado, Health Sciences Center, Denver, CO, U.S.A.

Christopher M. Filley, MD

Department of Psychiatry, University of Colorado, Health Sciences Center, Denver, CO, U.S.A., Department of Neurology, University of Colorado, Health Sciences Center, Denver, CO, U.S.A.

Neuropsychological rehabilitation is a new and unproven therapeutic concept. Despite the increasing availability and popularity of this kind of therapy, its efficacy remains to be established. We studied the outcome after an outpatient neuropsychological rehabilitation program in 16 patients, most of whom were young men with closed head injury. The program involved extensive pre-entry screening, cognitive retraining, traditional counseling services, and neurological and medical care. Most patients had pre-entry and postexit neuropsychological testing, and other outcome criteria were also assessed. Four patients were judged to have a good outcome in terms of changes in everyday functioning, nine to have a fair outcome, and three a poor outcome. Factors that tended to be associated with a poor outcome were substance abuse, emotional disturbance, unawareness of deficits, and poor motivation to participate. Neuropsychological test improvement was not impressive and did not always accompany functional improvement. Most patients showed progress on computerized cognitive retraining tasks, but the extent to which this progress generalized to everyday functioning was quite variable. Neuropsychological rehabilitation may be useful for some carefully selected patients with acquired cerebral lesions, but methodologically sound studies on patient selection and evaluation of specific methods need to be conducted. Key Words: Neuropsychology—Rehabilitation—Acquired cerebral lesions.

Neurorehabilitation and Neural Repair, Vol. 3, No. 3, 117-127 (1989)
DOI: 10.1177/136140968900300302


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