Rehabilitation tends to emphasize amelioration of physical deficits, but it is the cognitive, behavioral, and emotional sequelae of brain injury that family members consider so devastating and that team members find difficult to manage. Psychological Approaches to Rehabilitation After Traumatic Brain Injury, edited by Andy Tyerman and Nigel S. King, does a fine job of introducing these complex deficits and their treatment. Drs. Tyerman and King are consultant clinical neuropsychologists for the Community Head Injury Service in Aylesbury, United Kingdom, and thus have extensive experience working with this population. The book is targeted to clinical neuropsychologists as well as other multidisciplinary clinicians working with patients who have suffered traumatic brain injury (TBI).

The text is organized into five parts: service provision, cognitive rehabilitation, behavioral and emotional interventions, vocational rehabilitation, and family interventions. Case examples illustrate the presentations throughout. Chapter 1 provides an introduction to TBI. The editors describe the nature of TBI, its psychological effects, and measures of severity. The organization of TBI services in the United Kingdom is described, which the authors admit is inconsistent and dependent on where the patient resides.

The next four chapters make up Part I: Service Provision. In Chapter 2, Carpenter discusses acute neuropsychological rehabilitation services. She gives a realistic picture of the neuropsychologist’s role at this early stage, including the emphasis on patient education and anxiety reduction. In Chapter 3, McGrath gives us an insight into postacute inpatient rehabilitation, with discussion of post-traumatic amnesia (PTA) and sample questionnaires provided. Tyerman and King, in Chapter 4, describe community rehabilitation using their own service as an example. Worthington and Merriman discuss residential services in Chapter 5. Again, these diverse services are ideal; in actuality, their availability in the United Kingdom is spotty. Furthermore, many of the aforementioned services are unavailable in the United States, although the authors give some U.S. examples.

Chapters 6, 7, 8, and 9 address cognitive rehabilitation by domain. McKenna and Willson (Chapter 6) cover communication difficulties. Chapter 7, by Wilson, Evans, and Williams, describes rehabilitation of memory problems. Worthington and Riddoch detail the oft-neglected visual-perceptual and spatio-motor disorders in Chapter 8. In Chapter 9, Evans offers rehabilitation strategies for executive and attention problems. The latter chapter first analyzes the different components of executive functioning. In fact, each chapter in Part II contains a nice review of cognitive theory as background, reviews neuropathology, covers assessment of each domain, and addresses treatment techniques, with illustrative case studies. This reviewer has already referred to these chapters for useful ideas on cognitive remediation techniques, particularly those for executive functioning.

Part III reviews behavioral and emotional interventions. Chapter 10, Behavior Problems, addresses agitation, impulsivity, abulia, and unawareness, all common with TBI. Worthington and Wood include fascinating cases to illustrate their treatments. McGrath in Chapter 11, Fear, Anxiety and Depression, reviews the literature on the emotional consequences of TBI. He starts with theories and models and then moves on to discuss assessment and treatment recommendations. Also addressed in both chapters are the neurobiological underpinnings of mood and behavior changes in TBI. In retrospect, more could probably have been said in chapter 11 about substance abuse, a common problem in this population. Chapter 12, by King, comments on the overgeneralization that patients with PTA cannot develop posttraumatic stress disorder (PTSD) and that PTSD could still develop by way of the implicit memory system. Tyerman, in Chapter 13, summarizes methods for facilitating psychological adjustment in TBI patients. The term neuropsychotherapy is introduced, which refers to the use of neuropsychological knowledge in the psychotherapy of persons with brain disorders (Judd, Reference Judd1999). Given their extensive knowledge of brain–behavior relationships, clinical neuropsychologists would appear to be well suited to use this intervention for the benefit of TBI patients.

Vocational rehabilitation is reviewed in Part IV. This is an extremely important issue for patients but an area in which many neuropsychologists do not have expertise. Johnson and Stoten, in Chapter 14, write in general about return to previous employment, including numerous outcome studies. They outline the best time frame to initiate return-to-work, noting that most attempts are made too quickly, and key conditions that should be present to optimize a successful transition. Chapter 15, by Tyerman, Tyerman, and Viney, covers vocational rehabilitation programs, providing specific examples. Chapter 16, by Carew and Collumb, reviews job coaching.

Part V is concerned with family interventions. Chapter 17, by Oddy and Herbert, begins with a discussion of brain injury and the family in general and reinforces the concept of brain injury being a profound life-changing experience for the family as well as for the patient. Tyerman and Barton give a community service example of working with families in Chapter 18. In Chapter 19, Daisley and Webster broach the subject of the impact of TBI on children, giving examples of relevant interventions.

Overall, Psychological Approaches to Rehabilitation After Traumatic Brain Injury is an excellent resource for neuropsychologists working in rehabilitation settings and with brain injury patients, as well as for other rehabilitation professionals. It is well written, easy to read, and provides many helpful suggestions and references to aid in the application of a psychological approach to rehabilitation. Unfortunately, the book also highlights the great need for services for these patients and makes one realize that there is a serious lack of such services, at least in the United States. Nevertheless, this text encourages the development of these services by offering valuable information and ideas for treating patients who have experienced a brain injury.