Academic journal article American Journal of Psychotherapy

Psychotherapeutic Interventions for Adults with Brain Injury or Stroke: A Clinician's Treatment Resource

Academic journal article American Journal of Psychotherapy

Psychotherapeutic Interventions for Adults with Brain Injury or Stroke: A Clinician's Treatment Resource

Article excerpt

KAREN G. LANGER, PH.D., LINDA LAATSCH, PH.D., & LISA LEWIS, PH.D. (EDS.) Psychotherapeutic Interventions for Adults with Brain Injury or Stroke: A Clinician's Treatment Resource, Madison, CT., Psychosocial Press, 1999. 257 pages, price $35.00, ISBN 1-887841-23-7.

The editors of this collection of essays on the emotional, psychological, and rehabilitative therapeutic needs of patients who have suffered stroke or traumatic brain injury have assembled contributors from a number of different groups in the U.S. involved in the care of these patients. Serious interest and work in the area of the psychological, emotional, as well as cognitive and physical needs of this group of patients, has been significant only over the last two decades. But the accumulated experience in that time demonstrates that "attending to the patient's psychological recovery and growth is as predictive of overall outcome as the rehabilitation of cognitive and physical deficits" (p. xi).

The contributions in this book are divided into four conceptual areas: Part 1, a general background and history in the field; the neurobiology of the damage contributing to the outcome and manifestations of the conditions, and the ethical considerations involved; Part 2, the psychological defenses against acknowledgment of deficit, as well as the importance of defensive functioning, transference and countertransference when dealing with these patients; Part 3, the interplay of the psychotherapy with cognitive remediation which occurs with this type of injury; and Part 4, some specialized therapeutic approaches including the use of group psychotherapy, the importance of the family, and the issues of substance abuse in this population.

The various authors offer a basic understanding of the neuropathology and the importance of the area of damage to the brain, which is then reflected in the various pathological conditions and the symptomatology. The tone of all the contributions reflects an appreciation of the complexity of responses to brain trauma. The organic process leads to a variety of limitations or disturbances in emotionality, physical capacity, and cognitive response but the psychological factors are equally important. Preexisting personality, capacity for integration, and level of functioning have a profound effect on the extent of the damage and pathology that is manifest after the trauma. The ability to recognize and adapt to the functional losses include the capacity of the family to deal effectively with the patient's altered sense of self and possibly altered personality, and the patient's own altered self-image and its effects. …

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