A Performance-Based Group Approach to the Treatment of Anosognosia and Denial

Anosognosia and defensive denial frequently interfere with effective rehabilitation of the brain injured. An innovative performance-based group treatment approach was developed to manage these phenomena. Patients' predictions for their own performance were compared to their actual performance in a group format entitled the "Self-Awareness Group." The approach is described and data are provided demonstrating significantly improved self-predictions for performance both within and across treatment sessions, suggesting improved awareness of cognitive impairments and strengths. Techniques for facilitating generalization, as well as potential adverse treatment effects, are discussed.