Cognitive Therapy: What it is, How it Works and What it has to do with Rehabilitation from Catastrophic Injuries

Cognitive therapy is a type of psychotherapy. Developed primarily by Aaron T. Beck, it is based on the proposition that thoughts, behavior and feelings are connected to one another. It hypothesizes that individuals can overcome their challenges, meet their goals and achieve greater well being by changing the way they think and how they view their circumstances. Cognitive therapy involves the individual working with a therapist to develop skills for testing the validity of and, if necessary, modifying beliefs, identifying what may be distorted thinking about himself, herself or others, relating to others in different ways, and changing behaviors accordingly[1].

In many situations, including those involving catastrophic injuries, traumatic brain injuries including strokes, spinal cord injuries and the other very serious conditions that require the specialized rehabilitative expertise of NeuLife, the cognitive therapist plays a vital role. In conjunction with physical rehabilitation specialists, the cognitive therapist can help to create a client goal plan that adds psychotherapeutic expertise to the neurobehavioral, neurorehabilitative and other clinically relevant services to assist individuals achieve successful sustained outcomes. Cognitive therapy might, therefore, be analogized to physical therapy for the mind. The involvement of a cognitive therapist augments the individualized Client Goal Plan and is used to develop a psychological roadmap to understand the individual’s internal reality, select appropriate interventions, identify areas of distress and to correct or to adapt to them to achieve the best possible outcome.

Let’s use as an example an individual who has sustained a traumatic brain injury in an automobile accident while en route to work. Let us further assume that the work duties of the individual are high pressure, such as the supervision of many people and the responsibility for ensuring high levels of output of a high quality, and that the pressure has been successfully managed for many years. In that context, the assessment of whether or not cognitive therapy may be helpful (after medical stabilization) and if so, the implementation of it might progress in the following manner:

• The individual is very experienced in working in the stressful environment;
• The individual cannot return to the same type of high-level supervisory job due to the effects 0f the injuries sustained;
• Because of the duration of his or her experience in successfully managing the pressures of the job, the individual blames himself or herself for the accident, despite the reality of the causation (whether or not the cause of the accident was within or outside of the ability of the individual to control);
• There may be other types of work that the individual can perform;
• Because the individual has internalized the blame for the occurrence and  has not yet moved beyond the fact of occurrence of the traumatic brain injury, he or she views himself or herself as useless and as less of a person, which  leads to feelings of hopelessness and despondency, and which may carry over to other aspects of life; and
• As a result, the individual is unwilling to accept help or to assent to the implementation of a client goal plan that could include clinically relevant services such as rehabilitation, specialized rehabilitation or retraining to  propel the individual toward greater independence.

A study of several hundred prior studies of cognitive rehabilitation was conducted at the University of North Carolina at Charlotte and the University of Alabama. Researchers looked at the results from those prior studies that measured cognitive rehabilitation outcomes for individuals who sustained traumatic brain injury from trauma, stroke or loss of oxygen; they did not look at congenital abnormalities. The study concluded that cognitive therapy was generally useful, and specifically:

• It is preferable to start the therapy as early as possible, rather than waiting for more complete neurological recovery;
• Even older patients (55 and older) benefit from this therapy, even in the event of a stroke; and
• Therapists should focus on direct cognitive domains, such as attention and visuospatial processing. A more holistic approach seems to be less useful[2].

The professionals at NeuLife, including its team of psychologists, psychiatrists neurologists, RNs and therapists are expert in the provision of innovative, clinically relevant services, including the development of a customized Client Goal Plan, and delivery of neurobehavioral and neurorehabilitative services. NeuLife’s goal is to provide post-acute rehabilitation to its clients to achieve the best possible outcome for those who have even the most difficult and challenging diagnoses.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best accomplished in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to increase function and independence. NeuLife seeks to achievemaximized, sustained outcomes that exceed the expectations of all persons served.

NeuLife, in Mount Dora, Florida, is a fully accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.

NeuLife

2725 Robie Avenue

Mount Dora, Florida 32757