Achieving rehabilitative gains in anosognosia after TBI

Impaired self-awareness can be a serious consequence of traumatic brain inj ury (TBI) and has been associated with poor therapeutic compliance and poor functional recovery. Traditional rehabilitation approaches which make use of direct feedback and education are often ineffective because they elicit more elaborated and entrenched confabulatory beliefs as individuals are for ced to defend their position. Empirical case data is presented from a woman with profound anosognosia following a TBI with right frontal involvement. Targeted behaviors were decreased through behavioral interventions, bur the emphasis of treatment was on the formation of trusting, nonconfrontational therapeutic relationships. Marked reductions in inappropriate behaviors we re achieved along with a return to supportive community living. (C) 2000 Ac ademic Press.