The goal of traumatic brain injury therapy and rehabilitation is to help the impaired individual to progress to the highest level of functioning possible for maximal independence.
Brain injury rehabilitation involves two essential processes: restoration of functions that can be restored and learning new strategies when functions cannot be restored to pre-injury levels. Cognitive stimulation therapy plays a key role in the rehabilitation process. Brain injury rehabilitation is based on the nature and scope of the neuropsychological symptoms identified during a post-injury assessment.
Brain injury rehabilitation must account for a broad range of neuro-functional strengths and weaknesses in the brain of the injured patient. Basic skills (e.g. specifically attention, focus, perception skills) must be strengthened before more complex skills can be added (e.g. problem-solving, strategic analysis, etc.). This pattern of identifying functional strengths and weaknesses along with focused stimulation of the deficient areas is the foundation for designing a brain rehabilitation program.
Brain injury rehabilitation follows patterns of brain development. Gross or large-scale systems must be developed (or retrained) before finer systems. Attention, focus, and perceptual skills must be developed (or retrained) before complex intellectual activity.
Cognitive problems that result from traumatic brain injury vary widely from person to person. These problems depend on many factors including an individual’s personality, pre-injury abilities, and the severity of the brain damage, along with other influential parameters.
So long as the executive functions (logic, problem-solving, etc.) are intact, a person can likely sustain a considerable cognitive loss and still continue to be independent, constructively self-serving, and productive. When these higher order and more complex executive functions are impaired, they tend to show up globally, affecting all aspects of behavior. Executive functions consist of those capacities that enable a person to successfully engage in independent, purposeful, self-serving behavior. They differ from basic cognitive functions in a number of ways. Questions about executive functions involve how or whether a person goes about doing something (e.g., Will they do it, and, if so, how?)
Cognitive improvements can occur as other areas of the brain learn to take over the function of the damaged areas. This “learning” process is the key process by which the brain’s neuroplasticity is leveraged to regenerate existing neural pathways and find neural network detours around permanently damaged areas.
In some individuals, cognitive impairments often include problems with:
Individuals with traumatic brain injuries are often unaware of their cognitive deficits and can become frustrated or angry.
The rehabilitation of cognitive and communication problems is a continual, ongoing process. Once the physicians, speech-language pathologists, neuropsychologists, occupational therapists, and other professionals have assessed the extent of cognitive loss, communication skills, behavioral abilities, active daily living (ADL) capability, and hearing ability, a treatment plan can be developed. Cognitive and communication problems caused by traumatic brain injury are best treated early, often while the individual is still in the hospital. This early therapy will frequently center on increasing alertness and attention skills. They may focus on improving orientation to person, place, time, and situation, and using traumatic brain injury speech therapy activities to stimulate speech comprehension.
Longer term cognitive rehabilitation may be performed individually, in groups, or both, depending upon the needs of the individual. This therapy often occurs in a rehabilitation facility designed specifically for the treatment of individuals with traumatic brain injury. Therapies can be supplemented by traumatic brain injury rehabilitation exercises at home. The rehabilitation facility setting allows for intensive therapy by speech-language pathologists, physical therapists, occupational therapists, and neuropsychologists at a time when the individual can best benefit from such intensive therapy. Other individuals may receive therapy at home by visiting therapists or on an outpatient basis at a hospital, medical center, or rehabilitation facility.
The goal of rehabilitation is to help the individual progress to the most independent level of functioning possible. Therapy will focus on regaining lost skills as well as learning ways to compensate for abilities that have been permanently changed because of the brain injury. Most individuals respond best to programs tailored to their backgrounds and interests. The most effective therapy programs involve family members who can best provide this information and support the rehabilitation process.
USA Social & Health Services TBI Fact Sheet for Professionals click here.
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