Date of Award


Document Type

Doctoral Research Paper

Degree Name



Graduate School of Professional Psychology

First Advisor

Hale Martin, Ph.D.

Second Committee Member

Jennifer Cornish, Ph.D.

Third Committee Member

James Schraa, Ph.D.


Neuropsychology, Rehabilitation psychology, TBI, Traumatic brain injury

Publication Statement

Copyright held by the author. User is responsible for all copyright compliance.


Approximately 2.8 million US citizens sustain a traumatic brain injury (TBI) annually, with more than 275,000 requiring inpatient rehabilitation (Taylor, Bell & Breiding, 2013). As rehabilitation techniques are refined and adapted to increase the speed of recovery and functional independence following TBIs, there is an ongoing need for better prognostic assessment tools. Research has shown that a lack of self-awareness following TBI is associated with poorer outcomes (e.g. employability, community reintegration) following discharge from inpatient hospitalizations (Cheng & Man, 2006; Robertson & Schmitter, 2016) and can result in decreased motivation (Simmonds & Fleming, 2003), compromised safety, poor community re-integration, and impaired judgment (Hart & Sherer, 2009).

The paucity of empirical and objective measurements for a factor strongly correlated with rehabilitative success and prognosis and the lack of consensus about the nature of self-awareness, suggest a need for additional work to develop measures of awareness. Semi-structured interviews were conducted with experts in the field who provided information on their current practices, limitations, and aspirations for the assessment of awareness in those with traumatic brain injuries. Interviews were coded to aid the creation of a universal definition of self-awareness and the development of a meaningful and utilitarian assessment, as well as to identify future directions for the treatment of those with self-awareness deficits following traumatic brain injury. In summary, experts believe awareness should be defined based on the individual’s level of consciousness, awareness of functional limitations, and insight shown. If further assessment if required, experts proposed an approach that engages patients in pre and post-test reflection of their ability to complete a performative task. The discrepancy between their actual performance and their awareness of their performance could be quantified and used to measure current level of self-awareness and improvement over time. This assessment approach could help provide a quantitative measure of treatment efficaciousness.


38 pgs

Paper Method

Program Evaluation/Development, Theoretical Analysis and Synthesis