This chapter describes a young woman who was reported to be in a vegetative state for several months. She made a good cognitive recovery despite severe physical impairments but needed long-term support for emotional adjustment. This case illustrates how developing a shared understanding of Kate's strengths and difficulties with her and those around her was an important step toward re-establishing her sense of social identity. This, in turn, led to increased social participation.

Background and illness

Kate was born in 1970. She was the second daughter of a professional family living in Cambridge. She had a happy normal childhood with no serious illnesses. Her older sister trained as a medical doctor and Kate went to university to study history. After completing her degree Kate trained as a primary school teacher but because she felt her spelling was poor she chose to work at a nursery school near Peterborough. She was living with her boyfriend whom she hoped to marry and they planned to have several children. At the age of 26 years Kate developed a sore throat and a headache. Her mother described what happened.