Psychotherapeutic treatment of awareness in acute rehabilitation of traumatic brain injury

Abstract

A tripartite model for conceptualising lack of awareness after brain injury is proposed. Careful assessment of the causes of unawareness must precede treatment. Treatment in early inpatient rehabilitation should balance the patient's need to know with the implications, both positive and negative, of not knowing, at that point in time, for that individual patient. The challenge to the therapist is one of constant monitoring of dynamic fluctuations in a patient's readiness (neuropsychological or emotional) over time to become more aware of losses without becoming devastated by shame or despair.