Emotional adjustment after stroke: The role of early neuropsychotherapeutic interventions in patients following brain damage

  • Kemper Birgit
    Head Neuropsychologist, Special unit or early neurosurgical rehabilitation, Clinic for Neurosurgery, Director Prof. Dr. med. Uta Schick, Clemens Hospital, Academic Hospital of the Medical Faculty W.W.-University

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von Wild KRH, Kemper B. Emotional adjustment after stroke: The role of early neuropsychotherapeutic interventions in patients following brain damage. Jpn J Compr Rehabil Sci 2011; 2: 42-47.<br>Objective: Post-stroke depression has been considered the most common neuropsychiatric consequence of stroke, even in the presence of successful neurological recovery and good health-related quality of life. This report describes a patient’s catastrophic reactions to his unexpected illness, with a focus on the therapeutic process, to provide an understanding of managing denial and how to approach and engage brain-damaged patients.<br>Methods: This is a case study of a 65-year-old businessman with mental-cognitive and behavioral impairments following hypertensive cerebellar massive hemorrhage and secondary hydrocephalus, who made a complete recovery following psychotherapeutic intervention.<br>Results: Our supportive psychotherapeutic approach combined with cognitive interventions enabled this patient overcome moderate mental-cognitive and behavioral deficits and extreme defensive coping strategies, and facilitated his successful social re-entry.<br>Conclusions: Brain-damaged patients with preserved self-awareness and a high level of independence in activities of daily living (ADL), who do not have pre-existing psychiatric conditions, can benefit from individualized psychotherapy over time. Attention needs to be focused on a recovery beyond functional outcomes, with understanding of holistic neurorehabilitation as a (an )method of reconstructing lives within a social context. Further research and education is needed for the development of proper psychotherapeutic approaches to address aspects such as emotional coping and finding sense in life following brain damage.

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