Article

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.
OBJECTIVES: 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.
CONCLUSION: 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.

Langue : ANGLAIS