When personality meets progress

Throughout my time working as a Cognitive Rehabilitation Assistant (CRA) with the BIS Services, I’ve had the privilege of supporting a range of unique clients throughout different points in their rehabilitation journey, post acquired brain injury (ABI).

One key thing I have learned is that the success of the rehabilitation process depends as much on the quality of my relationship with a client as it does on the specialised support I provide. 

Cognitive rehabilitation following a brain injury is deeply personal. It is not just about improving cognitive function and introducing compensatory strategies, but about helping individuals rebuild confidence, autonomy and their sense of self following a life-changing, and often traumatic, event.

It is imperative that each client feels understood and supported by their CRA, forming a collaborative partnership grounded in trust and mutual respect in order for intervention to be effective.

At the BIS, CRAs are carefully matched with clients to ensure a good fit. Creating these matches starts with comprehensive assessments of both the client and the CRA, exploring their personalities, interests, and strengths. Clients are then paired with CRAs most suited to the clients needs and support preferences.

Open communication among clients, families, and multidisciplinary teams (MDTs)  ensures that further insight and adjustments can be made if a connection isn’t right. As CRAs, we also have a responsibility to nurture these relationships by listening actively, showing empathy and interest, and stepping into each client’s world with genuine care. 

A strong match can benefit rehabilitation in several ways. It can enhance motivation, as clients are more engaged when sessions feel meaningful. It fosters trust, creating a safe space to address challenges and setbacks. It also encourages resilience by providing clients with a supportive relationship that helps them navigate the oscillating nature of ABI recovery.

Finally, it allows for tailored interventions, ensuring strategies are adapted to resonate with the client’s unique preferences and needs.

Shared interests—whether it’s gardening, music, art or sport—create opportunities for meaningful engagement and can help shift focus to relieve perceived pressure, making rehabilitation feel less like ‘work’ and more like a shared journey. 

For example, when I first started working with one of my clients, he was extremely closed off and disengaged, appeared distrusting of me, and regularly isolated himself from me during our session times. Through discussions with his family and his MDT, I learned we had a shared hobby in going to the gym.

When I asked my client questions about the gym and his training routine, he began to engage a little more with me - at first, only around this subject. I was eventually able to encourage him to attend the gym with me during one of our sessions. Our rapport began to build and this became a weekly routine. Working together on a shared interest and goal, we were able to build a trusting relationship and he began to gain confidence and open up more to me.

From here, I was able to better understand his personal aims and help integrate some of his rehabilitation goals into his exercise regime, making them feel less like a chore for him, and we began to see progress. This experience affirmed for me that matching clients with CRAs who share their enthusiasm and interests can make rehabilitation a more rewarding and effective process.

When clients and CRAs connect over common ground, trust grows, and sensitive conversations about challenges or setbacks can become easier to raise and discuss. The more insight we as CRAs can gain into a client's  struggles, the more person-centred and tailored support we can provide, increasing the likelihood of successful intervention and positive outcomes.

Though ‘perfect’ client-CRA matches are not always possible, we have a duty to ensure we invest in formulating therapeutic relationships which are compatible with each client as an individual. 

Cognitive rehabilitation is as much about rebuilding relationships and identity as it is about strengthening skills. When clients are matched with CRAs who understand them on a deeper level, the process becomes richer, more effective, and more human.

These connections empower clients to not only reclaim their abilities but also their confidence and sense of self, illuminating the pathway to independence.

For me, this is what makes being a CRA so meaningful—knowing that the relationships I build with clients help create positive, lasting change. 

Rachell Maxwell is a Cognitive Rehabilitation Assistant and Social Media Lead at BIS Services. 

Learn more about BIS Services here.