Objective: The success of autonomous, self-directed career change after neurorehabilitation discharge indicates that the program graduate has become a true self-therapist, which is the central objective of the treatment program. Method: This case series of five graduates from comprehensive, intensive post-acute “holistic neuropsychological rehabilitation” (modeled on the Tel Aviv program of Ben-Yishay and associates) was based on follow-up interviews conducted between five and fifteen years post discharge. Each survivor sustained a severe diffuse TBI with a coma duration ranging from several days to several weeks. These injuries also included one or more focal lesions to the cortex. The duration of intensive treatment ranged from three to five months, and two of the five also received extended follow-up psychotherapy on a one hour per week to one hour per month basis. Results: At graduation four of the five survivors resumed their premorbid careers (as a plant designer and manager, a community liaison for a sports and recreation center, a personal trainer, and a theme park executive), while the last individual completed college and graduate school in speech-language pathology. Although each was successful in this vocational activity, all independently developed a new and very different career and held the new job at follow-up one or more years after making the change. Each survivor made a realistic career choice based on his or her metacognitive self-assessment, obtained requisite training, and redesigned his or her cognitive compensation strategies to apply to the new setting and tasks. The new careers (as a shipping and receiving supervisor, a rehabilitation educator, a middle-school classroom teacher, the statewide publicity director for a non-profit organization, and a business owner-operator) were exceptionally well chosen, and earned top ratings or recognition of excellence in four of the five cases. Conclusion: This study illustrates that survivors can be trained not only to cope with well-defined, immanent vocational responsibilities, but also to understand their brain function and recovery processes so well that they could effectively choose and adapt to new complex, demanding applications with no further professional assistance. This outcome reveals how well disability can be corrected by self-generalized, metacognitive compensation.
Autonomously Self-Managed Career Change after Intensive Post-Acute Cognitive Rehabilitation as Self-Therapy
L Schutz; A-83
Autonomously Self-Managed Career Change after Intensive Post-Acute Cognitive Rehabilitation as Self-Therapy. Arch Clin Neuropsychol 2015; 30 (6): 516-517. doi: 10.1093/arclin/acv047.83
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