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The Long Road Back: An Integrative and Interdisciplinary Approach to Care After Traumatic Brain Injury.
Yelu Zhang1, Kevin Majeres, Alejandro Dan Mendoza
1From Harvard Medical School (Drs. Zhang, Majeres, Mendoza, and Chiang); Department of Psychiatry (Drs. Zhang, Majeres, and Mendoza) and Department of Neurology (Dr. Chiang), Beth Israel Deaconess Medical Center, Boston, MA.
Harvard Review of Psychiatry
|May 14, 2026
Summary
Traumatic brain injury (TBI) recovery is complex, influenced by pre-existing conditions and psychosocial factors. An integrated approach using psychotherapy, biofeedback, and medication significantly improved neuropsychiatric symptoms and functional recovery in a complex case.
Area of Science:
- Neuroscience
- Psychiatry
- Rehabilitation Medicine
Background:
- Traumatic brain injury (TBI) frequently leads to neuropsychiatric issues, with recovery varying significantly.
- Factors beyond injury severity, such as pre-existing psychiatric conditions and psychosocial context, impact recovery.
- Complex neuropsychiatric sequelae following TBI pose significant challenges to patient well-being and functional reintegration.
Purpose of the Study:
- To present a case study detailing the complex neuropsychiatric symptoms following TBI in a patient with prior psychiatric comorbidity.
- To illustrate the effectiveness of a multidisciplinary, integrated treatment approach for managing TBI-related neuropsychiatric sequelae.
- To highlight the role of psychotherapy, pharmacotherapy, and technology-enabled interventions in optimizing recovery.
Main Methods:
- Case presentation of a young woman with a history of psychiatric comorbidity sustaining TBI from a motor vehicle accident.
- Utilized a coordinated, multidisciplinary treatment strategy focusing on symptom management and functional recovery.
- Employed a modified exposure-based psychotherapy, augmented with biofeedback and pharmacotherapy.
Main Results:
- The patient presented with posttraumatic headache, chronic pain, visual disturbances, work reentry difficulties, anxiety, and PTSD symptoms.
- The integrated treatment approach led to meaningful improvements in the patient's neuropsychiatric symptoms.
- Significant functional recovery was observed over the course of treatment.
Conclusions:
- Collaborative and tailored treatment is crucial for patients with overlapping neurological and psychiatric TBI sequelae.
- Psychotherapy, when combined with pharmacotherapy and technology-enabled interventions, plays a vital role in optimizing recovery.
- This case underscores the potential of integrative strategies for complex outpatient TBI presentations.
Keywords:
behavioral neurologyexposure therapyinterdisciplinary careneuropsychiatryposttraumatic stress disordertraumatic brain injuryMore Related Videos
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