Reduced or degraded self-awareness is frequently observed in TBI patients.

In other words, a patient often fails to believe that he/she has cognitive, emotional, neurobehavioral, and/or physical deficits. These, however, are often clearly evident to family, friends, and coworkers. Poor self awareness heightens one’s overall risk and therefore can hinder the road to independence. In addition, since the patient does not understand the full extent of his/her difficulties, it is likely that they will end up in situations that are embarrassing, risky, dangerous, and potentially life-threatening.

Achieving independence is certainly a process which cannot and should not be rushed.

Key factors include stability and consistency in behaviors, emotions/feelings, cognitive abilities, as well as judgment and reasoning skills. Objective observations and assessment, professional and family feedback, along with appropriate medical, psychological, educational, and vocational treatment and training can help facilitate this process.

Realistic goal-setting at different points in one’s recovery remains important. Often overlooked is the matter of social and interpersonal skills. That is, patients who demonstrate behavioral difficulties are often perceived to be incapable of achieving personal and social independence. However, provision of structure, routine, individualized reinforcement strategies, and attentive psychological care can support and promote improved neurobehavioral functioning and independence.