Integrating Rational Emotive Behavior Therapy, Compassion-Focused Therapy with Cognitive Retraining in Traumatic Brain Injury: A Case Report.

Abstract

Background: This case report presents a novel approach to treating Traumatic Brain Injury (TBI) by integrating Rational Emotive Behavior Therapy (REBT), Compassion-Focused Therapy (CFT), and Cognitive Retraining (CR). It contributes to the literature by demonstrating the effectiveness of a comprehensive psychotherapeutic approach in managing complex TBI sequelae, particularly in the Indian context where such interventions are underrepresented.

Case report: A 34-year-old Indian female presented signs of emotional dysfunction, cognitive impairment, social maladaptation, shamefulness, and self-deprecation following a TBI sustained 10 years prior. A mental status examination and psychological assessments revealed cognitive deficits, emotional instability, and irrational beliefs, all related to her injury and recovery. The treatment plan integrated REBT, to address the irrational beliefs; CFT, to manage the sense of shame and the insistence to self-criticize; and CR, to improve cognitive functions. This approach was tailored to the patient's cognitive limitations and cultural context. Interventions included challenging irrational beliefs, self-compassion imagery, and cognitive exercises adapted to her specific deficits. Outcomes were measured using the Subjective Units of Distress (SUD) scale and clinical observations. The patient showed improvements in emotional regulation, cognitive functioning, and overall quality of life, as evidenced by reduced subjective distress (SUD down from 90 to 58) and enhanced daily functioning.

Conclusion: This case demonstrates that an integrated psychotherapeutic approach combining REBT, CFT, and CR can effectively address the complex psychological and cognitive challenges of TBI patients. Tailoring interventions towards patient cognitive limitations and cultural context is crucial for a successful outcome. The case highlights the importance of incorporating diverse therapeutic modalities in TBI management, promoting a more holistic approach to recovery and enhancing the quality of life of TBI survivors.