ABSTRACT
Historically, neurological rehabilitation has relied upon several disciplines working together to achieve therapeutic goals. Indeed, a basic premise of rehabilitation medicine is that optimal patient recovery is built upon the concerted effort of several different treatment disciplines working as a team. Originally, the three professional groups comprising the rehabilitation team were medicine, nursing, and the clinical therapies (speech, occupational, and physiotherapy). With the passage of time, other professional groups became involved, such as psychology, recreational therapy, social workers, and, most recently, nonprofessional “therapy care assistants”. Not only has the number of different disciplines comprising a team increased, but the balance of “power” has changed, in the sense that responsibility of leadership is no longer automatically the province of the medical doctor, but has passed to psychologists or other health workers, according to the type of rehabilitation being provided. The evolution of rehabilitation teams has therefore been slow and fragmented, partly because neurological rehabilitation is a broad church (in respect of its range of subspecialities) and partly because some specialities have resisted giving ground to others. There is, however, growing support for the development of teams in a number of health-care areas. They have been advocated in primary care (Dingwall, 1980), psychiatry (Ovretveit, 1986; Royal College of Psychiatrists, 1984), and, more recently, in health care generally (Furnell, Flett, & Clarke, 1987).
