Article

New model of the adaptation process following acquired
brain injury, based on the patient's goals, the patient's abilities and the
emotional response to the changes and the possible discrepancy between goals and
achievements. BACKGROUND: The process of adaptation after acquired brain injury
is characterized by a continuous interaction of two processes: achieving maximal
restoration of function and adjusting to the alterations and losses that occur in
the various domains of functioning. Consequently, adaptation requires a balanced
mix of restoration-oriented coping and loss-oriented coping. The commonly used
framework to explain adaptation and coping, 'The Theory of Stress and Coping' of
Lazarus and Folkman, does not capture this interactive duality.
THEORIES: This model additionally considers theories concerned with
self-regulation of behaviour, self-awareness and self-efficacy, and with the
setting and achievement of goals. Our model proposes
the simultaneous and continuous interaction of two pathways; goal pursuit (short
term and long term) or revision as a result of success and failure in reducing
distance between current state and expected future state and an affective
response that is generated by the experienced goal-performance discrepancies.
This affective response, in turn, influences the goals set. This two-dimensional
representation covers the processes mentioned above: restoration of function and
consideration of long-term limitations. We propose that adaptation centres on
readjustment of long-term goals to new achievable but desired and important
goals, and that this adjustment underlies re-establishing emotional stability. We
discuss how the proposed model is related to actual rehabilitation practice.

Langue : ANGLAIS