All about rehabilitation

Rehabilitation Matters

About all rehabilitation

This site is unashamedly evangelical about rehabilitation, its importance to patients and their families, its never-ending fascination, and its intellectual, philosophical, ethical, and emotional challenges. It is a personal website that expresses a personal view of rehabilitation, based on over 40 years of experience, research, writing, and, most of all, thoughtful consideration. It is based on evidence, not afraid to challenge orthodox beliefs where they need to be challenged, and, I hope, interesting.

Overview of Rehabilitation Matters

This site is for everyone interested in rehabilitation, from experts to those with no prior knowledge, from rehabilitation professionals and other healthcare workers to politicians, patients, and the public, from those who pay for services to those who provide them, and, above all, it is for people who are curious about rehabilitation.

This site concerns all healthcare rehabilitation regardless of age, setting, or condition. Although my main interest is in neurology, the content considers all conditions, including psychiatry, visual and hearing impairments, functional disorders, and drug and alcohol rehabilitation.

So, as the strapline says, this site is all about rehabilitation and about all rehabilitation. The figure below outlines the main sections.

Unique focus

I am unaware of any other sites centred on rehabilitation. Academic journals, such as Clinical Rehabilitation (which I edited) and Archives of Physical Medicine and Rehabilitation, publish articles on specific topics. Sites such as the British Society of Physical and Rehabilitation Medicine or the Society for Research in Rehabilitation have a particular focus (medical aspects or research). Textbooks, such as the Oxford Handbook of Rehabilitation Medicine, have chapters on various topics, but rarely discuss the rehabilitation process.

The content will inevitably reflect my philosophy and approach. I believe rehabilitation must be centred on the person, always consider longer-term social goals, and that rehabilitation professionals need to develop wisdom, which is the best way to respond to the many uncertainties and complexities associated with many of our patients. We must remain humane, remembering that patients are people.

Everyone must consider the philosophical, legal, and ethical challenges related to rehabilitation. For instance, what are the differences between disease, disability, sickness, and illness, or, equally important, what is rehabilitation? Ethical questions arise daily, such as when considering people with prolonged disorders of consciousness or functional disorders.

I give more details in the About section.

Who should read it and why?

Everyone! Most people ask, “What is rehabilitation?” The site should answer this question, whether you are a patient recently offered rehabilitation, a politician or policymaker, or simply someone curious.

Professionals involved in rehabilitation should find much to interest and educate them. I challenge common assumptions, explain complex concepts, and present facts and arguments they can use when promoting rehabilitation. I am especially keen on education and training. I have created a curriculum and syllabus suitable for all professions. It fosters expertise in rehabilitation as a complement to their existing knowledge and skills. My approach stems from my involvement in developing the medical rehabilitation curriculum and should engage students and anyone training in rehabilitation.

Service managers and policy makers, because their understanding of and commitment to rehabilitation are crucial. I discuss person-centred rehabilitation on several pages and posts, emphasising that organisational support is vital. The team’s ability to be person-centred can be severely constrained by unsuitable budgetary or management frameworks.

Furthermore, rehabilitation should be a collaborative, cross-boundary enterprise, rather than a competitive matter, shifting responsibility to other parties. For example, high-level funders and policymakers should actively support rehabilitation networks.

Healthcare professionals, including all managers, should read to gain insight into rehabilitation. A better understanding of rehabilitation is needed throughout the healthcare system, as many patients would benefit from rehabilitation but are not referred. The site has information on the role of nursing homes in rehabilitation. Social Service professionals will also find much of interest, as social care is indistinguishable from rehabilitation.

Patients, their families and friends will also learn a great deal about rehabilitation. The content avoids jargon where possible and explains complex ideas clearly. Additionally, a section is dedicated to the patient and the public, which I hope will also engage healthcare professionals.

Newly published: September 17 to November 10, 2025

I have concentrated on exploring the use of the biopsychosocial model of illness. The first post considered biopsychosocial healthcare. My argument begins with the observation that healthcare systems evolved alongside many other scientific ideas from the 1600s, and these ideas primarily manifest as the biomedical model of illness, which I have already discussed. However, since about 1950, the biomedical model has been failing with the rapid increase in controlled but not cured diseases and a lack of social support for the increasing number of people with chronic disease. The healthcare system based on the biomedical model is no longer appropriate, and I propose that a biopsychosocial framework for healthcare and other services is crucial if we are to have a sustainable healthcare system.

I was asked to discuss the biopsychosocial model with a group of medical students interested in rehabilitation, which led to a post explaining the model from its fundamental principles. The post is aimed at non-rehabilitation specialists – healthcare professionals and the public. I emphasise the importance of systems (General Systems Theory), and being person-centred, then demonstrate how they compel you to develop the biopsychosocial model. The post is the basic biopsychosocial framework.

The third post discusses essential work by John Whyte and his colleagues, who have developed the concept of Enablement Theories and a specific method for describing rehabilitation treatments, known as the Rehabilitation Treatment Specification System. The papers I consider expand on vital aspects of rehabilitation, both the biopsychosocial model of illness, which underlies the enablement theories, and the role that theories suggesting effective treatments play in developing and describing interventions. My conclusion is that the papers represent significant progress, but they overlook the complexity of rehabilitation.

The last new post, entitled Malady, revisits an idea I discussed in another post, Disease, Illness, Sickness, and Disability. I propose that we should use the term malady to describe the state of anyone feeling unwell, regardless of whether others, such as healthcare professionals or family members, recognise them as unwell. I examine in detail a paper published in 1981 that considered malady in the context of sickness, disease, and related concepts. I suggest that malady results from a failure to maintain a sustainable biopsychosocial balance; the General Theory of Rehabilitation is based on this concept.

I have also published two new pages, both prompted by lectures I have been asked to deliver.

The first considers the key attributes of a specialist rehabilitation service. I was due to deliver this talk two weeks after my right total hip replacement, but the operation was postponed for two weeks! I delivered a virtual presentation, and wrote the page to back up the talk. The page draws extensively on the work in the guidance on providing rehabilitation in specialist nursing homes.

The second relates to rehabilitation thinking, a vital skill. I gave a lecture on this in London, and I am scheduled to present an updated version in Germany next month. It is based on a paper I authored for Clinical Rehabilitation. My hypothesis is that the only core skill explaining the effectiveness of rehabilitation across a broad range of disorders and settings is the cognitive approach employed by rehabilitation experts.