Neuroclinical Psychology strand of acquired brain injury
Acquired brain injury is a frame-breaking change that has a catastrophic impact on people’s lives. Not only does it reduce functional effectiveness in the simplest activities of daily living, but it changes the way people perceive themselves and are perceived by others. Family, social and work relationships deteriorate and sometimes socio-economic circumstances worsen as well.
The combined cognitive and emotional impairments together with a loss of continuity in the way one experiences oneself shrink the frontiers of personal mastery, so that our clients often describe themselves as being ‘unable to even make a cup of coffee’. The impairments in the cognitive and emotional systems generate a state of impaired self-hood which clients describe as a loss of dreams and of future. This crystallises into an experience of discontinuity which clients often express as me-before/me-after. This sense of discontinuity is also mirrored in the lives and expectations of their loved ones.
Clients, their families and carers report that adjustment to the aftermath of the brain injury is extremely difficult. Not only do impairments generate frustration in everyone involved, they also create feelings of shared helplessness because of the mistaken belief that nothing can be done about the situation. This then causes further spillage and disruption of the entire system
Our Psychologist Team work with our clients to mobilise their potential for resilience and resourcefulness to regain functional effectiveness, to develop their adaptive capability to adjust to the post injury order of their lives, and to achieve mastery of their world.
When the head-injured person is discharged from a rehabilitation facility, a number of problems begin to develop within the family the most prominent of which is the realisation that the person’s problems are long-term. This realisation is quickly followed by an apprehension regarding the lack of support previously provided by the rehabilitation facility.
The 'ccent team work to resolve these problems through four key strategies that help our clients and their families to re-integrate into a cohesive functional unit.
These strategies are:
1. Training to:
- recognise and to cope with the various components of frame-breaking and frame-bending changes
- manage stress and other emotional and behavioural problems effectively
2. Educating on:
- consequences of brain injury
- understanding of long term recovery
- developing the skills that will sustain recovery
3. Cognitive Behaviour Therapy to
- develop adaptive capability to adjust to the post injury order of life
- achieve mastery of the challenges of change
4. Collaborating with all professionals involved with our client to achieve a trans-disciplinary perspective that will deliver the optimal treatment and care
Our rehabilitation with our brain injured client begins with a comprehensive and detailed neuropsychological assessment. The results of this assessment inform on our client’s:
- Current functional level and capabilities
- Therapeutic and rehabilitation needs and priorities
- Rehabilitation goals and strategy
Estimated treatment time-line,, evaluation benchmarks and definition of expected outcomes and criteria of success
Our progress evaluation seeks to answer three central questions:
1. Did each rehabilitation stage produce the desired changes
2. Did these changes result in a significant increase in the life quality and independence of our client and his/her family
3. Are these changes enduring
Our systemic work with our client and his/her family always involves the entire family unit. Our central assumption is that the family is an interactive unit so that changes in one element of the system necessarily result in changes in other members within the system.
Our ultimate goal in working systemically with our client and family is to achieve a new balance within the system after its previous equilibrium has shattered as a result of the frame-breaking experience of brain injury. Critical therapeutic objectives include ongoing education, help with problem-solving and communication, stress reduction and rebuilding the family into a cohesive functional unit.
Figure 01 sets out our treatment and rehabilitation strategy in the neuro-clinical neuropsychology strand of acquired brain injury.
Figure 01: summary treatment and rehabilitation strategy for brain injured clients and their families
View video by Leyla Ziyal about Depression and PTSD in patients with Acquired Brain Injury.