This text discusses counseling interactions that may be used with clients following traumatic brain injury. In order to be effective, counseling must not only facilitate a person's capacity for self-determination in the face of external barriers, but also help clients gain access to and awareness of the inner psychological processes that influence their decisions. It requires that the counselor understand the various ways in which the traumatic brain injury may be manifested and the common cognitive, emotional, and personality disturbances that can occur. Topics covered include psychological disturbances after traumatic brain injury, neuropsychologically mediated and organic problems, emotional reactions to injury, pre-injury personality characteristics, psychological assessment, counseling interactions and the therapeutic relationship, and specific interventions for cognitive and behavioral problems related to vocational rehabilitation procedures and outcomes.

For a period of some fifteen years following completion of my internship training in clinical psychology (1950-1951) at the Washington University School of Medicine and my concurrent successful navigation through that school's neuroanatomy course, clinical work in neuropsychology for me and the psychologists of my generation consisted almost exclusively of trying to help our physician colleagues differentiate patients with neurologic from those with psychiatric disorders. In time, experience led all of us from the several disciplines involved in this enterprise to the conclusion that the crude diag nostic techniques available to us circa 1945-1965 had garnered us little valid information upon which to base such complex, differential diagnostic decisions. It now is gratifying to look back and review the remarkable progress that has occurred in the field of clinical neuropsychology in the four decades since I was a graduate student. In the late 1940s such pioneers as Ward Halstead, Alexander Luria, George Yacorzynski, Hans-Lukas Teuber, and Arthur Benton already were involved in clinical studies that, by the late 1960s, would markedly have improved the quality of clinical practice. However, the only psychological tests that the clinical psychologist of my immediate post-Second World War generation had as aids for the diagnosis of neurologically based conditions involving cognitive deficit were such old standbys as the Wechsler Bellevue, Rorschach, Draw A Person, Bender Gestalt, and Graham Kendall Memory for Designs Test."

For a period of some fifteen years following completion of my internship training in clinical psychology (1950-1951) at the Washington University School of Medicine and my concurrent successful navigation through that school's neuroanatomy course, clinical work in neuropsychology for me and the psychologists of my generation consisted almost exclusively of our trying to help our physician colleagues differentiate patients with neurologic disorders from those with psychiatric disorders. In time, experience led all of us from the several disciplines involved in this enterprise to the conclusion that the crude diagnostic techniques available to us circa 1945-1965 had garnered little valid information on which to base such complex, differential diagnostic decisions. It now is gratifying to look back and review the remarkable progress that has occurred in the field of clinical neuropsychology in the four decades since I was a graduate student. In the late 1940s such pioneers as Ward Halstead, Alexander Luria, George Yacorzynski, Hans-Lukas Teuber, and Arthur Benton already were involved in clinical studies that, by the late 1960s, would markedly have improved the quality of clinical practice. However, the only psychological tests that the clinical psychologist of my immediate post Second Wodd War generation had as aids for the diagnosis of neurologically based conditions involving cognitive deficit were such old standbys as the Wechsler-Bellevue, Rorschach, Draw A Person, Bender Gestalt, and Graham Kendall Memory for Designs Test."

For a period of some fifteen years following completion of my internship training in clinical psychology (1950-1951) at the Washington University School of Medicine and my concurrent successful navigation through that school's neuroanatomy course, clinical work in neuropsychology for me and the psychologists of my generation consisted almost exclusively of trying to help our physician colleagues differentiate patients with neurologic from those with psychiatric disorders. In time, experience led all of us from the several disciplines involved in this enterprise to the conclusion that the crude diag nostic techniques available to us circa 1945-1965 had garnered us little valid information upon which to base such complex, differential diagnostic decisions. It now is gratifying to look back and review the remarkable progress that has occurred in the field of clinical neuropsychology in the four decades since I was a graduate student. In the late 1940s such pioneers as Ward Halstead, Alexander Luria, George Yacorzynski, Hans-Lukas Teuber, and Arthur Benton already were involved in clinical studies that, by the late 1960s, would markedly have improved the quality of clinical practice. However, the only psychological tests that the clinical psychologist of my immediate post-Second World War generation had as aids for the diagnosis of neurologically based conditions involving cognitive deficit were such old standbys as the Wechsler Bellevue, Rorschach, Draw A Person, Bender Gestalt, and Graham Kendall Memory for Designs Test."

For a period of some fifteen years following completion of my internship training in clinical psychology (1950-1951) at the Washington University School of Medicine and my concurrent successful navigation through that school's neuroanatomy course, clinical work in neuropsychology for me and the psychologists of my generation consisted almost exclusively of our trying to help our physician colleagues differentiate patients with neurologic disorders from those with psychiatric disorders. In time, experience led all of us from the several disciplines involved in this enterprise to the conclusion that the crude diagnostic techniques available to us circa 1945-1965 had garnered little valid information on which to base such complex, differential diagnostic decisions. It now is gratifying to look back and review the remarkable progress that has occurred in the field of clinical neuropsychology in the four decades since I was a graduate student. In the late 1940s such pioneers as Ward Halstead, Alexander Luria, George Yacorzynski, Hans-Lukas Teuber, and Arthur Benton already were involved in clinical studies that, by the late 1960s, would markedly have improved the quality of clinical practice. However, the only psychological tests that the clinical psychologist of my immediate post Second Wodd War generation had as aids for the diagnosis of neurologically based conditions involving cognitive deficit were such old standbys as the Wechsler-Bellevue, Rorschach, Draw A Person, Bender Gestalt, and Graham Kendall Memory for Designs Test."