SIMREB – towards a systematic inquiry into models for rehabilitation

Abstract

Systematic Inquiry into Models for Rehabilitation (SIMREB) is a framework for designing evaluations of rehabilitation models specifically intended for persons who are only to a limited extent regarded as being capable to speak for themselves and who, therefore, are often entrusted to a professional assessment of their needs. The article identifies the general elements in this model. By looking at both the epistemological level and the practice level from a professional as well as a user perspective the model taps into discourse analysis, institutional ethnography and a wide tradition of evaluation research. The article uses an evaluation of a rehabilitation programme for people with traumatic brain injury (TBI) as an example to illustrate the different elements of the SIMREB model.

Contradictions and conflicts in brain injury rehabilitation. A systematic inquiry into models of rehabilitation

“…The SIMREB model (Høgsbro 2010), employed as a theoretical framework to conduct the examination, consists of four different levels (A, B, C and D) and three different aspects (1, 2 and 3) ( Figure 1).…”

“…The SIMREB model is a meta-design focussing on the interaction between professionals and individuals with ABI, and it is seen as part of a wider tradition of IE (Høgsbro 2010;Schmidt 2005). People in the roles of patients, clients and users of institutional services are regarded as linked to a life-world perspective limited by a certain horizon which makes it impossible to fully understand the conditions and dynamics of a professional system (Habermas 1981;Schmidt 2005;Schutz and Luckmann 1989).…”

“…This paradigm entails the risk of creating a self-fulfilling prophecy or a kind of autopoiesis (Luhmann 1984). That is, the lack of motivation, insight and initiative can be seen both as a neurological and a pedagogical issue and the reference to, for instance, a 'frontal lobe trauma' might protect the professionals from a critique of the rehabilitation programme they can offer the individuals with ABI (Høgsbro 2002(Høgsbro , 2010. In a social paradigm, we cannot predict who has the potential to recover because it is not only determined by the injury itself, but also very much connected to the social support as well as personal factors.…”

“…This article examines the degree to which the bio-psycho-social model (BPSM) is being implemented in rehabilitation practices by using the Systematic Inquiry into Models for Rehabilitation (SIMREB) model (Høgsbro 2010) as an investigative tool. In brief, the SIMREB model emphasises four levels of a rehabilitation programme: the episteme and its discursive references to international theories and frames of reference, professional practice, the users' experience of the professional practice and the life-world they refer to when understanding their own problems and future perspectives.…”

Evidensbaseret praksis - forhåbninger, begrænsninger og muligheder

“…ETIBA-undersøgelsen vedrørende de danske tilbud til førskolebørn med autisme, kan i denne sammenhaeng tjene som eksempel på et komplekst design, der i nogen grad lå indenfor rammerne af en institutionel etnografi (Høgsbro, 2007;2010).…”