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Chapter Five: Layers of Culture: Its Influence in a Milieu-Oriented Holistic Neurorehabilitation Setting




  • Perumparaichallai, Kavitha R.
  • Klonoff, Pamela S.


Cultural beliefs have a tremendous influence on a person’s perception of disability. Viewing culture as a discrete system that encompasses interconnected components should enhance the cultural competence in rehabilitation centers. The manifold layers of culture include the: culture of origin, mainstream culture, brain injury culture, therapists’ culture, and the culture of the neurorehabilitation program. With the increased emphasis on cultural sensitivity, health care training programs have been focusing on enhancing the cultural sensitivity and competency of health care providers. These health care provider aspects also very much apply to the therapists in neurorehabilitation settings. The milieu-oriented neurorehabilitation program creates a unique culture that is different from other cultural influences encountered by an individual. Neuropsychologists in the Center for Transitional NeuroRehabilitation (CTN) milieu program play an important role in fostering a culturally sensitive and competent interdisciplinary team and in translating cultural considerations into concrete treatment approaches and goals.