ASSESSMENT AND TREATMENT OF IMPAIRED AWARENESS AFTER BRAIN INJURY - IMPLICATIONS FOR COMMUNITY RE-INTEGRATION

Impaired self-awareness of deficits is a common finding in patients wh o have suffered traumatic brain injury. Impaired awareness can limit m otivation for treatment and contribute to poor outcome. Consequently, it is important for brain injury rehabilitation professionals to under stand this phenomenon and utilize treatment approaches that may improv e patient awareness. The present article reviews the existing literatu re on measurement of impaired awareness, characteristics of impaired a wareness, the relationship of impaired awareness to functional outcome , possible treatment approaches for impaired awareness and empirical i nvestigations of interventions to improve awareness. The treatment str ategies we use to address impaired awareness in our community re-integ ration program for brain injury survivors are described in detail. The se approaches include: establishment of the therapeutic alliance, fami ly interventions, peer feedback, education, roleplaying, videotape fee dback, real world experiences, therapeutic milieu and psychotherapy. ( C) 1998 Elsevier Science Ireland Ltd.