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Leitartikel

Grundlagen und Empirie der Neuropsychologischen Therapie: Neuropsychotherapie oder Hirnjogging?

Published Online:September 01, 2006https://doi.org/10.1024/1016-264X.14.4.217

Abstract

Zusammenfassung: Dieser Beitrag beschäftigt sich mit dem theoretischen Fundament und den empirischen Grundlagen neuropsychologischer Interventionen. Nach einem kurzen historischen Rückblick werden die konzeptionellen Grundlagen einer neuropsychologischen Behandlung dargestellt und erläutert. Neuropsychologische Interventionen werden drei Therapiesäulen zugeordnet: Restitution, Kompensation und integrierten Verfahren. Restitution bezieht sich auf Maßnahmen, mit denen gestörte neuronale Systeme wieder reaktiviert werden sollen. Kompensation beinhaltet den aktiven oder passiven Ausgleich von Funktionsdefiziten durch vorhandene Fähigkeiten. Hierzu zählt nicht nur das Lernen neuer Strategien und der Einsatz von Hilfsmitteln, sondern auch die Veränderung von Erwartungen, Lebenszielen und andere kognitive Anpassungen. Integrierte Verfahren stellen Verfahren (z. B. operante Techniken) anderer Psychotherapierichtungen dar, die bei einer neuropsychologischen Behandlung Anwendung finden können und auf die Bedürfnisse von Patienten mit organisch bedingten psychischen Störungen zugeschnitten sind. Die in dem Beitrag referierten Studien unterstreichen die Bedeutung der drei postulierten Therapiesäulen.


The Theoretical and Empirical Foundation of Neuropsychological Treatment: Neuropsychotherapy or Brain Jogging?

Abstract: This paper describes a theoretical framework for understanding neuropsychological treatments. After a short historical review three important mechanisms (restitution, compensation, and integrated interventions) are proposed which guide the development of neuropsychological treatment techniques and the process of therapy. The notion of restitution of function assumes that behavioral improvement results from the increasing integrity of the injured functional system. Such an improvement can be obtained by specific stimulations which foster reconnection of damaged neural circuits. Hebbian learning mechanisms play an important part in this. The compensatory approach to recovery is required when a permanent loss of function is expected. Compensation refers to a set of strategies (e. g., developing new skills, altering one's goals and expectations, selecting alternative niches or alternative goals) which are used to overcome or adapt to losses or deficits. Integrated interventions are therapeutic techniques borrowed from other psychotherapy schools and adapted to the needs of patients with organic mental disorders. The paper concludes with a consideration of how the proposed framework might be used to develop a scientific neuropsychotherapy.

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