COGNITIVE RETRAINING AS A PSYCOTHERAPEUTIC TOOL AND VICE VERSA: A CASE STUDY

Abstract

We report a right-handed, 32 years old patient who suffered a severe traumatic brain injury (TBI) resulting in extensive epidural hematoma in the right fronto-temporo-parietal lobes and subdural hematoma in the left frontotemporal lobes. He was referred to the Brain Injury Day Treatment Unit of ELEPAP Athens one-year post injury. His initial neuropsychological assessment revealed severe cognitive deficits in a wide range of cognitive domains with language and memory being the most prominent. More specifically, he exhibited difficulties in perception and information processing, which in combination with his disorganized speech, resulted in a great state of confusion. His cognitive deficits were accompanied by behavioral disturbances, such as perseverations, agitation, irritability and outbursts. His state of confusion resulted in a total denial to comply with any verbal and/or behavioral cues he was provided with, making his participation in any group/peer and individualized activity almost impossible. Despite the strong emphasis on building a strong therapeutic alliance with his counselor through weekly counseling sessions and everyday peer interaction, the results were still poor. In order to engage him in the rehabilitation process, some tailor made cognitive exercises were provided, based on his preserved mental strengths, aiming at helping him excel and work independently. As a result, he felt less, stressed, more competent and more aware and open to discuss his everyday problems during his weekly meetings with his counselor. In time he got more malleable and could fully participate in the rehabilitation process.