Lebensziele in der neuropsychologischen Rehabilitation. Empirische Befunde und therapeutische Implikationen.

Acquired brain injury not only leads to cognitive deficits, but often entails persistent motiva-tional and emotional problems. A high comorbidity with psychological disorders is well-documented. Treatment of these complex issues requires integration of neuropsychological and cognitive-behavioral intervention techniques. In order to implement a treatment evaluation of an out-patient neuropsychological psychotherapy, a treatment program was developed which com-bines the aforementioned techniques. Within the framework of this ongoing randomized controlled trial, the present dissertation in-vestigated the therapeutical relevance of life-goals. Limitations in the attainability of important life-goals are an individual representation of complex sequelae of acquired brain injury. Addi-tionally, they offer a suitable framework and a measure of quality of treatment of individualized neuropsychological rehabilitation. The central tenets of two models of basic psychological research were examined in a sample of post acute study participants as well as in a sample of acute neurological in-patients in order to make existing knowledge available to neuropsychological therapy. Indeed, two hypotheses of the teleonomic model of subjective well-being ( Brunstein, Schultheiß, & Maier, 1999) could be corroborated: It is not sufficient to possess important life-goals. Decisive for subjective-well-being is the perceived success in attaining these goals. More-over, realizability of important life-goals moderates the relationship between goal importance and goal success. Discrepancies between goal importance and goal success as focused in the dual process model (Brandtstädter & Rothermund, 2002) are greater in both examined clinical samples than in healthy controls. The magnitude of these discrepancies relates to subjective well-being. Reduc-ing the discrepancies through improvement of assimilative and accommodative strategies may represent a promising therapeutic intervention. Based on these results, the current dissertation presents empirically and theoretically founded propositions for life-goal interventions in neuropsychological rehabilitation. The purpose therein is not to replace methods of established neuropsychological therapy but rather to individualize them, thereby increasing motivation for therapy.