I believe this book is absolutely needed for clinicians who are working with individuals with brain injury. It not only addresses the need for psychotherapy but also provides hands-on, useful tools to clinicians who are conducting psychotherapy. Information and suggestions were provided in a useful, cohesive, and concrete way and the book was extremely easy to understand, which makes it a pleasurable read. The book had great use of illustrations, figures, tables, and case examples. I loved the presentation of scripts used by the author when working with clients. The book outlines the importance of emotional functions, psychotherapy, and changes in personality functioning for individuals not familiar with brain injury. It was nice to see specific questions presented that a clinician could ask the client throughout the book in all the chapters. This is helpful, concrete information and suggestions for the therapist to use, particularly those who might need a little extra assistance in taking the abstract concepts and turning those into useful clinical tools. The authors did a lovely job at reminding clinicians, new and experienced, that it is important to keep in mind the patient's experience when they are being assessed and treated. They remind us to stop and imagine what it would be like to be in the patient's shoes and see the world through the patient's lens.
The book is divided into two primary sections: first, understanding and diagnosing emotional changes following acquired brain injury and second, psychotherapeutic interventions adapted for patients with acquired brain injury. With respect to the first section, they did a lovely job presenting the theoretical concepts in a manner easily understood. The authors did a lovely job at stressing the significance of attending to the long-term psychological needs of individuals with ABI. Many clinicians believe that emotional challenges may occur more during the first year following the injury, but research and clinical evidence demonstrates that individuals develop ongoing psychological co-morbidities and catastrophic reactions after recovery starts to slow down. The information contained in this section also teaches the clinician how to explain the brain–emotion connection in a way that patients can appreciate. The psychotherapy process is often void of the psychoeducation piece and especially in this population, it is imperative to present individuals with as much psychoeducation on this process as possible, including family members.
The authors begin Part II by discussing modifications that should be used in psychotherapy when treating individuals with ABI. An emphasis is placed on encouraging clinicians to consider some important theoretical concepts underpinning the emotional changes experienced by individuals with ABI. Emotional challenges emerge as individuals attempt to accept their new “altered-self.” As such, the authors attempt to help clinicians gain a macroscopic and to some degree, an existential perspective of the patient's experience.
The information presented in the chapters on anxiety, depression, and anger is paramount. The authors discuss the rationale for providing interventions, conceptualizations for where these emotional challenges come from and what maintains the symptoms, suggest assessment techniques, and suggest specific tools and interventional strategies, via use of scripts and step-by-step suggestions. I loved the segment on “To be Happy or Not be Happy—Is That the Question?” This segment is particularly useful given that we sometimes have unrealistic expectations, do not know what the true concept of happiness means, and we also live in an all-or-nothing world where we believe that if we do not have “complete happiness,” then we are not truly happy. They did a nice job of presenting information in a manner that would be easy for clinicians to explain the concepts of happiness and well-being to patients. With respect to the chapter on Anger, I appreciated their thoughts and ideas on forgiveness, which is often a difficult topic in therapy. Often times, we just want to tell people, “get over it.” The authors manage to present ideas in a way that allows the therapist know where to even start.
Finally, the authors speak to what is ultimately at stake, one's sense of meaning and purpose, which ties into their identity. Clinician's get so caught up in the details, we forget to step back and take a look at the big picture. The authors provide wonderful and easy to understand illustrations and case examples of this. I was also very thankful they incorporated a section on faith and spirituality. This is extremely important, as for those who are spiritual/religious, this may be the most important factor guiding their coping and sense of meaning.
I would absolutely recommend this book to other neuropsychologists involved in psychotherapy with individuals with ABI, regardless of their skill set. One weakness of the text is that scripts and recommendations on techniques would have been more readily accessed if presented in script boxes or tables. Otherwise, this is one of the first books of its kind and highly needed in the field of brain injury rehabilitation.