Commentary on Using Client-Centered Psychotherapy Embedded Within A Pluralistic Integrative Approach to Help a Client With Executive Dysfunction: The Case of "Judith" Providing Psychotherapy to People with Neuropsychological Impairment: Complexities and Issues Raised by the Case of ‘’Judith’’

Ward and Hogan (2015) present a case study of ‘’Judith’’ where a combination of client-centered psychotherapy, cognitive rehabilitation and social support result in very positive outcomes despite neuropsychological impairments being present and these posing challenges to the intervention. The case study highlights a number of very important issues when providing psychotherapy to clients with cognitive impairments. These include: 1) the common requirement that issues of self identity are explored; 2) the common need for adaptations to be made to the delivery of psychotherapy to mitigate against the effects of cognitive impairments on psychological interventions; 3) the need for specialist neuropsychological rehabilitation services to be available to such clients in the long-term and for specialist neuropsychological supervision to be available to clinicians working psychotherapeutically in this area; and 4) the demonstration that emotional growth and positive psychotherapeutic results are possible even when neuropsychological challenges are present. The extent to which these important issues are fully demonstrated by the case of Judith is limited in three main ways: a) there being some lack of clarity regarding the severity of the head injury sustained; b) there being a lack of psychometric data to confirm the type and severity of the cognitive impairments present; and c) there being some ambiguity regarding the relative contribution of organic and psychological factors to Judith’s neuropsychological problems.