Rehab Insights is a weekly blog written by Burke Rehabilitation professionals to offer practical information for patients, families and the community. It's goal is to educate the reader on relevant topics in rehabilitation, general health and wellness.

The Neuropsychologist’s Role in the Treatment of Brain Injuries

June 9, 2015

22879098_xl copyWhat is a brain injury?
When someone suffers a brain injury, their world instantly turns upside down and they are forced to deal with a constellation of unfamiliar and often upsetting issues that they never had to previously confront.

Public awareness of Traumatic Brain Injury (TBI) is slowly increasing, primarily as a result of greater exposure by the media to sports and combat related injuries. The general public, however, still fails to give brain injury the recognition and legitimacy it deserves. Routine conventional imaging may not always indicate subtle cognitive brain injury, even though it exists. Furthermore, there are many misconceptions about brain recovery following injury.

The brain is the most complex organ in the body. It controls and coordinates everything from our breathing to the involuntary rush of butterflies we feel when we experience our first love.

Cognitive issues in people with brain injury typically include problems with attention and concentration, impaired memory and learning, slowed processing speed and reduced problem-solving abilities. Emotional and behavioral challenges are also common and can include delayed onset of depression and/or anxiety, as well as problems with anger management, irritability and difficulty with emotional control.

Almost every individual who suffers a brain injury feels misunderstood. As a result, they often isolate themselves from their loved ones and yearn for affirmation of their brain injury. It's important to remember that they're not faking it.


Approach to treatment
The neuropsychologist treats individuals who have suffered a brain injury, whatever the cause, and helps them and their loved ones navigate this winding, unpredictable and exhausting journey that is full of uncertainty and fear.

Treatment is comprehensive, focusing on the whole individual, not only their specific condition. No two people are alike; similarly, every brain injury is unique.

It is important to understand that a neuropsychologist addresses cognitive and emotional issues. In contrast to physical disabilities (e.g. a broken leg), these problems are usually not apparent on the outside. Often, many of these invisible symptoms—irritability, depression, impulsiveness—don’t manifest until an individual returns home.

The therapeutic approach addresses each individual’s unique clinical picture by pinpointing their specific physical, cognitive, and behavioral challenges, as well as any other aspects of the clinical picture that may complicate treatment efforts. Neuropsychologists administer tests that clarify how an injury has altered the brain’s ability to process information and explain specific changes in behavior. These tests determine rehabilitation needs and guide the treatment.

Cognitive exercises emphasize teaching compensatory strategies focusing on using each individual’s unique strengths to offset specific deficits. The ultimate goal is a practical approach tailored to each individual’s particular everyday needs. Psychotherapy is also an integral part of the treatment and focuses largely on adjustment to disability and injury. The process deals with some of the associated psycho-social issues, taking into account the fact that the brain is not working the way it used to.

Many individuals only realize they had a traumatic brain injury long after the event. “I wish someone would have taken the time to explain the injury to me...” Brain injury is often confusing to the family as well. When you care for a loved one with a brain injury, it’s easy to get burnt out and say things out of frustration. For this reason, family members must be actively involved in the treatment process.

At Burke, we offer a continuum of care which starts in the inpatient rehabilitation unit and carries on to our outpatient setting, with specialized services including assessment, cognitive remediation, psycho-social treatment and family interventions. Our services are conducted in one-on-one and group settings to fully address the needs of each individual.

—Heidi Spitz, Psy.D., Director, Outpatient Neuropsychology at Burke Rehabilitation Center 

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Burke's Rehab Insights blog is intended to provide general information about rehabilitation and other health care topics. It should not take the place of medical care. Burke staff cannot comment on individual medical cases or give medical advice.

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