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Counseling and Brain Injury

dark green text on white with a light green background, text reads: "Change can be scary, and brain injury can result in a life changing scenario; and it is okay to need help to manage these changes."

So, you have a brain injury, and your life has changed. Do you need psychotherapy and counseling?

This is not an uncommon question and is also a great thing to ask yourself. In some cases, you may already know the answer. If you don’t, that’s okay. Change can be scary, and brain injury can result in a life changing scenario; and it is okay to need help to manage these changes.


Unfortunately, you may be intimately familiar with this scenario: you sustain a brain injury, a traumatic brain injury or a stroke, possibly. You get thorough acute and post-acute treatment with brain injury specialists and then you are discharged. You continue to receive speech and language therapy, occupational therapy, physical therapy, as well as periodic medical assessment and treatment as needed from brain injury professionals. The problem is, you have not also been referred to a psychotherapist who specializes in working with people post brain injury, individuals who are wondering why they are feeling, for example, sad, anxious, and angry. Is it directly biologically caused by the brain injury? Is it instead a psychologically shocked reaction to a major neurological event?

After a brain injury, there are often many different behavioral, cognitive, and emotional changes. You (or someone who knows you well) may notice these changes and advise getting mental health counseling. So now, you have the question of where to go? You will quickly realize that there are numerous behavioral health practitioners out there. How do you decide who to choose? Do you want to see somebody who mostly sees people with non-brain injury related psychopathology or instead, a brain injury counseling specialist? Mental health treatment often looks different for people with brain injury. This is because although people with brain injury may show up a clinician’s office with what outwardly looks like depression, however their treatment needs to be specialized, since their brain is screaming “depression” for injury-related reasons. The good news? Post brain injury, your brain is rewiring itself. Thus, therapy tailored to assist people in such a situation helps that rewiring process go in the right direction.

I am adamant that people referred to the above rehabilitation specialists post brain injury also need to be referred to somebody like me, a psychotherapist who specializes in brain injury.

– Dr. Hillel “Hill” Goldstein, brain injury psychotherapist

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