Holistic neuropsychological rehabilitation in Finland: The INSURE program—a transcultural outgrowth of perspectives from Israel to Europe via the USA

Abstract

Given the interaction of cognitive, behavioural, psychological, and physical factors resulting from traumatic brain injury (TBI), a comprehensive, multidisciplinary, and neuropsychologically oriented rehabilitation could prove to be particularly promising and efficacious in the neuropsychological rehabilitation of post‐acute brain‐injured individuals. Kurt Goldstein, an eminent pioneer in the development of holistic rehabilitation, stated that brain‐injured patients need environments that help them to avoid catastrophic reactions. In his view, the tasks of rehabilitation are to create, for the brain‐injured individual, an environment that will minimize the chances for the occurrence of catastrophic responses. In this environment, the individual can engage optimally in various remedial activities, which will gradually culminate in the individual finding new meaning in life after rehabilitation. Yehuda Ben‐Yishay incorporated many of Goldstein's ideas and developed a milieu or holistic rehabilitation program in 1978 in New York. The emerging role of psychotherapy for patients and their family members was characteristic of the Neuropsychological Rehabilitation Program that Prigatano established in 1980 in Oklahoma. In Europe, Anne‐Lise Christensen, who was also influenced by the work of A. R. Luria, started a holistic program at Copenhagen University in 1985. Based on these pioneering programs, several similar programs were established in Europe. A Finnish program, INSURE, was established in 1993 in Helsinki. The INSURE program is a post‐acute, interdisciplinary, 6‐week rehabilitation program for selected groups of TBI patients. The core of the program is neuropsychological rehabilitation and psychotherapy with vocational interventions, and follow‐up support. In recent years, a holistic rehabilitation program was also established in Turku for children with acquired brain injury. The European Holistic Working Group was founded in 2001, and the authors will also discuss their personal experiences and future of holistic neurospychological rehabilitation in terms of ongoing research work, computer‐administered cognitive remediation, and quality of life assessment.

The effectiveness of computer-assisted cognitive rehabilitation in brain-damaged patients

“…In clinical practice, meanwhile, it is often just a fragment of a larger rehabilitation program, e.g. holistic neurorehabilitation (Coetzer, 2008;Sarajuuri & Koskinen, 2006;).…”

George P. Prigatano’s contributions to neuropsychological rehabilitation and clinical neuropsychology: A 50-year perspective

“…Anne-Lise Christensen (1927-2018, influenced by the work of Ben-Yishay and Prigatano, founded a holistic program in 1985, the Center for Hjerneskade in Copenhagen (Denmark) (Caetano and Christensen, 1999). In 1991, Marja-Liisa Kaipio created a holistic program at the Käpylä Rehabilitation Centre (Kaipio et al, 2000;Sarajuuri and Koskinen, 2006). In November 1996, the Oliver Zangwill Center was inaugurated in Ely (England), thanks to the perseverance and tenacity of Barbara A.…”

Relationship between late objective and subjective outcomes of holistic neurorehabilitation in patients with traumatic brain injury

“…Both holistic neurorehabilitation programmes address cognitive, meta-cognitive, affective and interpersonal concerns within the settings of therapeutic community types of programmes. 11,31 Psychotherapy and cognitive training are carried out in individual and group formats. In addition, important elements of the holistic programmes are tailored and supported work trials, as well as follow-up procedures.…”