Changes in self awareness can affect a person’s actions and relationships.  This can result in difficulties for the individual as well as the family.  Impaired self awareness can limit or slow recovery because individuals may not follow therapy or treatment recommendations.   Efforts by family members to help can be especially frustrating if the person insists that “everything is fine” or  “I don’t need help.”  This tip card describes 4 major causes of altered awareness after a brain injury and provides tips and strategies for therapists and caregivers.