Glasgow and cognitive behavior therapy EN

The Glasgow Coma Scale (GCS) scores from 3 to 15, where:

• 15 = fully awake and oriented
• 7 or less = considered a coma
• 8–14 = various degrees of impaired consciousness

If someone has a GCS score of 7/15, they are in a severe coma (severe brain injury category).

BUT:

• The GCS score itself measures the acute state of consciousness — it does not directly define the long-term degree of invalidity (disability).
• The degree of invalidity depends on how the person recovers after the coma (rehabilitation, neurological sequelae, etc.).

In Swiss Invalidity Insurance (IV/AI) terms:

• After a coma with a GCS of 7, if the person fully recovers = possibly no invalidity (or minor).
• If there are lasting impairments (physical, cognitive, psychological), then the degree of invalidity is assessed case-by-case, mainly based on the impact on working capacity.

Rough general guideline based on medical outcomes:

• If there are mild sequelae (memory problems, slight motor deficits) → degree of invalidity could be 20–40%.
• If there are moderate sequelae (significant cognitive deficits, serious physical handicaps) → 40–69%.
• If there are severe sequelae (loss of autonomy, need for assistance) → 70% or more (entitling to full pension).

Conclusion:

• GCS 7/15 means a severe coma, but the IV degree of invalidity must be evaluated later based on the person’s real-life recovery, autonomy, and work capacity.
• There is no automatic percentage just because of the initial GCS.
• A medical assessment (neurological, psychiatric, and functional evaluation) will be needed to establish the official IV disability rate.

Best Practices of CBT after Mild Brain Injury (like Ms. B)

1. 

Psychoeducation

• First step:
  Therapist explains how brain injury can cause emotional swings, anxiety, fatigue, concentration problems — normalizing her experiences.
• Goal: Ms. B understands it’s not “her fault” but a medical consequence.

2. 

Energy Management and Pacing

• Teach how to manage fatigue:
  
• Break tasks into small steps.
• Prioritize daily activities.
• Schedule regular rest periods before exhaustion sets in.
• 
  
• CBT here works on thought patterns like “I must do everything perfectly” → replacing them with “I need to balance my energy.”

3. 

Cognitive Restructuring

• Identify and challenge negative thoughts:
  
• Examples:
  
• “I’m useless now because I can’t do my old job.”
• “People will think I’m stupid.”
• 
  
• Replace with more realistic thoughts:
  
• “I’m adapting to my new situation.”
• “Everyone needs time to heal.”
• 
  
• 
  

4. 

Anxiety and Emotional Regulation

• Teach specific CBT skills:
  
• Relaxation techniques (deep breathing, grounding exercises),
• Mindfulness exercises (staying present rather than overthinking future fears),
• Exposure to anxiety triggers step-by-step (e.g., slowly returning to busy environments).
• 
  

5. 

Cognitive Skills Training (if needed)

• If attention, memory, or planning are still weak:
  
• Memory strategies (lists, alarms, notes),
• Attention exercises (mindful focusing on one task),
• Problem-solving skills.
• 
  

Important:

CBT after brain injury adjusts the pace — sessions may be shorter, simpler, more concrete because the brain tires more easily.

6. 

Goal Setting and Gradual Return to Activities

• Set small realistic goals:
  
• For example: “Answer 3 work emails without feeling overwhelmed,” “Attend a 1-hour social event.”
• 
  
• Celebrate small victories to rebuild self-confidence.

7. 

Involve Family or Work if Needed

• Sometimes, include:
  
• Family coaching to understand mood swings or fatigue,
• Workplace adaptations (quiet room, flexible hours).
• 
  

How Often and How Long?

• Typically:
  
• One session per week,
• For 12–20 sessions.
• 
  
• Longer if needed, especially if anxiety or depression is deep.

Progress is measured not just by talking, but by actual small improvements in daily life.

Shrinkflation in Switzerland 2025

 Hard times, slow times.

Father of a little one, i noticed these since beginning of the year. Mostly in one supermarket i go to but others have same examples:

Baby pouch reduced from 90 to 85 g  between 2024 and 2025

https://www.migros.ch/en/product/521031400000

Laundry price increase by 30% from 10,50 to 13,50 between Marcand Apr 25

https://www.migros.ch/en/product/500154300000

Between creche and social services with long queue and waiting list, Switzerland is not really welcoming immigrants to have kids. Ok the environment, school, landscapes, culture and languages are top notched but at what price… and not speaking of the welcoming across the Rostigraben…

Shrinkflation in Switzerland: An Invisible Economic Pressure

Introduction

In an era of rising global costs and economic uncertainty, businesses are finding increasingly creative methods to manage their financial pressures. One such method is “shrinkflation,” a phenomenon where the size, weight, or quality of a product is reduced while the price remains the same or even increases. Although this practice is not new, it has gained prominence in Switzerland over recent years, particularly in the aftermath of the COVID-19 pandemic and amid global supply chain disruptions. Swiss consumers, known for their discerning standards and sensitivity to quality, have begun to experience shrinkflation in sectors ranging from everyday consumer goods to essential services like air travel. This essay examines the manifestations of shrinkflation in Switzerland, using concrete examples such as the decrease in Migros’ eco laundry detergent and baby food pouches, alongside the notable rise in airline fares post-COVID. It also explores the economic and social implications of shrinkflation, arguing that it presents a hidden but significant challenge to consumer trust and purchasing power in one of the world’s wealthiest economies.

Shrinkflation in Consumer Goods: Everyday Examples

One of the most visible arenas for shrinkflation is the supermarket. Migros, one of Switzerland’s largest and most trusted retailers, has quietly reduced the size of several products without a corresponding reduction in price. A case in point is the eco laundry detergent, which has been downsized from 90 grams to 85 grams. On the surface, the change seems negligible, almost imperceptible to the average shopper. However, when considered across hundreds of thousands of units sold annually, this minor adjustment translates into significant savings for the retailer—and a hidden cost for the consumer.

Similarly, Migros’ baby food pouches, a vital product for families with infants, have undergone similar reductions in quantity. For parents carefully planning their budgets in a country where the cost of living is among the highest globally, such covert changes erode purchasing power. Products that once sufficed for a full meal or snack for a baby may now require additional purchases to meet the same nutritional needs. While the packaging and branding often remain unchanged to avoid alerting consumers, the contents inside quietly diminish, undermining consumer expectations and loyalty.

These examples illustrate how shrinkflation operates subtly but effectively, shifting financial burdens from producers and retailers onto consumers without the transparency that accompanies direct price increases.

Shrinkflation Beyond Goods: The Case of Air Travel

The phenomenon of shrinkflation extends beyond tangible products into the realm of services, particularly travel. The airline industry, severely impacted by the pandemic, has resorted to measures akin to shrinkflation to recuperate losses. In Switzerland, major carriers such as SWISS International Air Lines significantly increased ticket prices after COVID-19 travel restrictions were lifted. Yet, travelers often received reduced value for the higher prices they paid.

Post-pandemic air travel has been characterized by fewer flight options, decreased staffing levels, longer wait times, and reduced onboard services such as complimentary meals or checked baggage allowances. Thus, although ticket prices have surged, the quality and convenience of the travel experience have, in many cases, deteriorated. Consumers are effectively paying more for less—a hallmark of shrinkflation applied to the service industry.

This dynamic is particularly striking in Switzerland, where efficiency, punctuality, and high-quality service are national expectations. For frequent travelers and tourists alike, the disparity between cost and experience has become increasingly evident, contributing to growing dissatisfaction and altering perceptions of value in Swiss travel services.

Economic and Social Implications

The economic implications of shrinkflation are profound. At the macro level, shrinkflation allows companies to protect their profit margins without confronting consumer resistance typically associated with visible price hikes. By decreasing product sizes or services incrementally, businesses maintain the illusion of price stability while stealthily increasing their effective revenue per unit.

However, at the micro level, consumers are the ultimate victims. Shrinkflation undermines purchasing power in a less visible, but equally damaging, way as inflation. In Switzerland, where wages are high but so are living expenses, even small reductions in product quantity or service quality can have cumulative effects on household budgets over time. This is especially critical for vulnerable groups such as young families, pensioners, and low-income workers.

Socially, shrinkflation risks eroding consumer trust. Swiss consumers are known for their brand loyalty and willingness to pay premium prices for high-quality goods and services. However, when companies engage in shrinkflation without transparent communication, it fosters a sense of deception. Over time, this can weaken brand reputation and consumer confidence, leading to a more skeptical and less forgiving market environment.

Conclusion

Shrinkflation represents a subtle but significant economic force in Switzerland today. Whether through reduced quantities of household staples like Migros’ eco laundry detergent and baby food pouches or through the post-pandemic escalation of airline ticket prices coupled with declining service quality, Swiss consumers are increasingly paying more for less. While shrinkflation may offer a temporary solution for companies facing rising operational costs, it risks long-term damage to consumer trust and market stability. In a country that prides itself on quality, transparency, and fairness, addressing shrinkflation openly—and seeking alternative solutions to protect both businesses and consumers—will be crucial for maintaining Switzerland’s economic integrity and social cohesion in the years to come.