Introduction

How should we plan and evaluate rehabilitation? We will argue here that the most appropriate way to plan, direct and measure the success of rehabilitation is through the process of goal setting. If neuropsychological rehabilitation is ultimately concerned with enabling people with brain injury to participate effectively in valued activities, then it follows that we should measure the outcome of an individual's rehabilitation programme in terms of whether or not the programme enables that individual to achieve his/her personal goals. If outcome is defined in terms of personal goals, then it makes sense that these goals should be the central focus when planning the specific components of a rehabilitation programme.

In relation to evaluation of outcome, if one is evaluating a specific treatment intervention that aims to improve a particular cognitive function, then it is useful to have an assessment of that cognitive function as an outcome measure. However, even when evaluating a specific treatment it is important to measure the extent to which the intervention improves the client's functioning in his/her everyday life. Some studies aiming to evaluate cognitive or neuropsychological rehabilitation programmes use standardized neuropsychological tests as their main, or only, outcome measure (see, for example, the studies reviewed by Carney et al., 1999). We would argue that use of such tests, on their own, either to plan or to evaluate rehabilitation programmes is wrong.