Recovery from a brain injury is not only about physical rehabilitation – it also involves understanding the broader ways in which the brain can be affected, and how these changes influence everyday life. This is where our Clinical/Neuro Psychologists play a vital role.
At the heart of our neurological rehabilitation service, our neuropsychology team works closely with clients to understand the emotional, behavioural, and cognitive effects of neurological conditions, from memory and attention difficulties to changes in mood, personality, and decision-making.
When cognition is affected, a comprehensive neuropsychological assessment supports our team to develop a bespoke, holistic treatment programme tailored to each clients’ goals and needs.
The assessment itself is a key starting point. It allows us to explore the specific impact of a client’s neurological condition, uncover both strengths and areas of difficulty, and inform the most effective pathway forward.
To bring this process to life, we’ll be sharing a real case study that highlights how a neuropsychological assessment works, and the meaningful difference it can make in someone’s recovery journey.
Case Study:
In 2023, Mr. S, an HGV driver and father, set out on a routine motorcycle journey. Within hours, he was airlifted to hospital following a serious road traffic collision. He sustained multiple traumatic injuries, including a subarachnoid haemorrhage (SAH) and a subdural haematoma (SDH). These are two types of bleeds on the brain that can affect thinking, memory, emotions, and physical functioning.
Following stabilisation in intensive care, Mr. S began the long process of recovery. He moved from ICU to a general hospital ward and later to a specialist rehabilitation unit. While he received physiotherapy and occupational therapy for his physical injuries, other issues began to emerge that were less visible.
Recognising Cognitive and Emotional Change
After returning home to his partner and young child, Mr. S noticed that he found it harder to recall information and occasionally had trouble putting his thoughts into words. His partner also noticed changes, describing him as more forgetful, irritable, and lacking confidence.
These issues are not unusual after a brain injury, but they can be difficult to understand and explain. They can affect day-to-day functioning, relationships, and emotional wellbeing. Mr. S was referred for a neuropsychological assessment to better understand his cognitive and emotional functioning.
What Is a Neuropsychological Assessment?
A neuropsychological assessment is a structured evaluation that helps identify how the brain is working following illness, injury, or significant stress. While scans can show brain structure, neuropsychological assessments focus on function.
Assessments often examine cognitive domains such as:
- Memory
- Attention and concentration
- Language and communication
- Reasoning and problem-solving
- Emotional wellbeing and mood
The assessment process includes a clinical interview and practical tasks, such as pen-and-paper or verbal activities. These help build a detailed picture of cognitive strengths and weaknesses. The assessment also explores how changes in thinking may relate to fatigue, mood, or pre-existing traits.
For Mr. S, the assessment aimed to:
- Understand what might have changed in his thinking skills since his injury
- Provide guidance to his rehabilitation team for treatment planning
- Identify his cognitive strengths to support recovery
Assessment Insights: Strengths and Difficulties
Mr. S was engaged and motivated throughout his assessment, which took place across several sessions. He put in consistent effort but often criticised himself, reflecting the emotional pressure he was under. He described feeling as though he was “failing” despite trying hard.
Cognitive Strengths
- Visual-spatial reasoning remained a clear strength, consistent with his professional background
- Planning and problem-solving skills were preserved, supporting his return to part-time work
- Attention and working memory were in line with his estimated pre-injury abilities
Areas of Difficulty
- Word-finding was a challenge at times. He had difficulty naming objects in structured tasks, although this was less evident general conversation
- Verbal memory was weaker than expected, particularly when recalling information read aloud to him without prompts
- Processing speed was slightly reduced, especially when he was fatigued or switching between tasks
Although these difficulties were relatively mild, they caused frustration when Mr. S found himself forgetting tasks or struggling to find the right words during conversation.
Mood and Mental Wellbeing
Mr. S reported a persistently low mood and scored within the moderate range for depression. He acknowledged experiencing thoughts of assisted dying, which tended to diminish during periods of increased independence, such as when he was able to drive or return to work part time. However, these thoughts often resurfaced in response to functional or practical setbacks.
Initially unsure about therapy, Mr. S began to consider psychological support as part of his recovery. A collaborative crisis plan was developed, including contacts for urgent support, and was shared with his partner and clinical team.
The Importance of Joined-Up Rehabilitation
Dr Rebecca Andrews, our Clinical Psychologist in Neuropsychology comments, “Not every individual requires a comprehensive neuropsychological cognitive assessment. Sometimes it is more appropriate to evaluate cognitive function through everyday activities or to focus on specific cognitive domains.
However, in Mr. S’s situation, after a significant brain injury and with the goal of returning to work while supporting a young family, a thorough assessment was essential. This detailed evaluation helped us understand how his injury affected his thinking and emotions, allowing us to distinguish these changes from his pre-injury baseline.
With this insight, we were able to develop a holistic, person-centered rehabilitation plan that incorporated expertise from multiple disciplines.”
The neuropsychological assessment provided valuable insights that informed a more coordinated treatment plan. Mr. S’s case was discussed by the multidisciplinary team, with contributions from the following professionals:
- Clinical Neuropsychology; who interpreted the assessment findings. Neuropsychology also continues to provide emotional support, and liaise with his GP and case manager regarding risk management in the community.
- Occupational Therapy; who continue to support upper limb rehabilitation and desensitisation, offer strategies for managing cognition and fatigue, and have initiated discussions about returning to driving-based roles at work in the future.
- Physiotherapy; who adapt physical goals in line with Mr. S’s energy and motivation levels, helping him re-engage with meaningful activities such as returning to the gym and holding his child’s hand, despite sensory challenges.
- Speech and Language Therapy; who conducted further assessments of his communication and word-finding abilities.
This joined-up approach supports Mr. S as a whole person: a parent, a partner, an employee, and an individual adjusting to life after trauma.
Could a Neuropsychological Assessment Help?
Mr. S’s journey with Hobbs Rehabilitation following his brain injury is a powerful example of the difference neuropsychological input can make. His story reflects not only personal resilience but also the vital role that neuropsychological assessment plays in guiding both the therapist and the wider clinical team. By gaining a deeper understanding of the impact of his injury, we were able to personalise a treatment approach that truly met his needs.
If you or someone you support has experienced changes in their thinking skills, behaviour or mood following a neurological condition, a neuropsychological assessment may provide clarity and direction.
Our team offers evidence-based assessments tailored to individual needs. We work collaboratively with clients and professionals to build informed care plans that support recovery in the real world.
To enquire about our Clinical Neuropsychology service, please head to our Contact page.