Counseling services are a valuable part
of restoring balance to a person's life. The foundation of counseling
success is an interactive partnership between the client, the
client's support group, and the counselor.
Anyone's life can become out of balance
due to common events. Usually, there are several events occurring
at the same time. At this point, anyone can benefit from counseling
services. In counseling sessions, a client learns insight into
self and coping mechanisms. Many people have coping mechanisms,
but the mechanisms may be ineffective, inappropriate, or immature.
Examples of lessons to learn in counseling
sessions are: behavior modification, stress management, effective
coping skills, assertiveness training, conflict resolution, parenting
education, anger resolution, social skills, cognitive therapy,
social skills, and more.
I counsel adolescents and adults. I
usually work with individuals experiencing anxiety disorders,
learning and attention disorders, mood disorders, relationship
disorders, brain injury impairments, and personal skill issues.
Counseling Traumatic Brain Injured
Clients
Counseling of the traumatic brain injury
(TBI) population requires that the counselor be very experienced
in cognitive retraining of brain injured persons. Typically,
brain functions (thinking skills) are the primary tool used in
counseling for learning new techniques, for introspective reflection,
and for conceptualization. However, the brain injured person
usually demonstrates signature behaviors that interfere with
the process of learning. The signature behaviors of TBI are:
impulsivity, poor judgement, misperception of the intentions
& actions of others, slow information processing, memory
disturbances, and irritability. When counseled in the context
of the signature behaviors, the TBI client can benefit from counseling
and the entire rehabilitation process.
TBI clients also are vulnerable to psychological
impairments as a result of their brain injury. Examples of these
impairments are:
- Impaired capacity or social perceptiveness,
self-centered, decreased empathy, decreased self reflection,
and decreased self critique
- Impaired capacity for self-control,
self regulation, random restlessness
- Stimulus bound leads to social dependency
- Emotional changes (personality changes),
increased apathy, silliness, irritability, emotional lability,
and increased/deceased sex drive
- Personality regression as in increased
dependency, childlike behavior, decreased ability to cope
- Cannot profit from experience; decreased
social learning
- Conceptual and behavioral rigidity
- Disruption of previously learned social
behavior: context, frequency, duration, sequence
- Denial inability to recognize
and accept actual deficits; can't perceive impact of actual deficits
- Increased awareness of disability resulting
in: (a) depression with sadness, inactivity, self-destruction,
agitated behavior; (b) anger characterized by irritability &
bitterness.
- Lowered self-esteem when recognizing
they are different from before the injury
- Exaggeration of previous "personality
traits" - usually an inappropriate version of previously
acceptable or even positive traits
The Road to Recovery
Even though the psychological and cognitive issues of a TBI
client are many and difficult, there are predictable and identifiable
stages during the recovery
process. These stages were developed by Karen Lloyd,
PhD at the Center for Comprehensive Services, Inc., in Carbondale,
Illinois. Click here
for an outline of those stages.
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