This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on TBI and Depression. Dr. Chuck Bombardier discusses Why It's Important to Make Adjustments to CBT.

If a person with brain injury went to a cognitive behavior therapist who wasn’t really familiar with TBI, you might see – the patient might become, for example, overwhelmed, overstimulated, and that might trigger some either fatigue and putting their head down or irritability and anger, agitation because there’s too much coming in at once, that they’re being asked to do too many things at once.

So – and the therapist who’s not familiar with brain injury might interpret that as the person’s not wanting to be there or can’t do this, poor motivation, et cetera, instead of realizing that they’re running up against some TBI limitations that they need to accommodate.

With a person with brain injury, we probably would try to break it down into smaller chunks. We’d probably allow them more times to try it. We’d probably provide them with more help to do it, so we might engage a helper to carry it out. We’d do a number of things to provide some scaffolding to help ensure greater success. We’d be more lenient. Patient. We’d take more sessions to do it, 16 sessions instead of 10 or so.

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