Cognitive disorders: Searching for the circumstances of effective treatment: Introduction by the symposium organizer

Abstract

Cognitive deficits associated with neurologic disease or damage are quite common and they are known to negatively impact the lives of patients, caregivers and society at large. Unfortunately, documented effective rehabilitation of cognitive deficits is extremely scarce. In addition the concept of cognitive rehabilitation is usually viewed with tremendous skepticism. This pessimism is manifested in so many ways: It is found in the reluctance of skeptical physicians to refer patients to rehabilitation clinicians, it is seen in the reluctance of service payers to fund clinical efforts, it gets reflected in the graduate training programs which place cognitive rehabilitation in the lower echelons of curricular priorities, it underlies the dearth of funded programs in cognitive rehabilitation research, and it even permeates professional organizations and journals where “treatment studies” represent an extreme minority of presentations and articles. The most salient explanation for this therapeutic nihilism is the implicit belief that “everyone knows it doesn't work.”