i am a psychotherapist for inviduals with traumatic brain injury?

Question

i just began (i am actually in my internship phase, however i am the sole therapist for my clients).

what would you recommend ? (books, techniques, things to keep in mind, etc.?)

thanks

Answer 1

Respect. No matter how old they seem to act - they are the age they are - treat them like adults.



They may need support to do what they want to do and not succeed. They do not need to be protected from failure- they do need to be protected from not believing in themselves and their ability to make decisions and take risks.

Answer 2

Here's a somewhat different perspective--but Ihighly recommend it.



The mental health professions, along with rehabilitation professions, focus on the individual. That's not a criticism--their (your) job is to help the client learn to deal with issues, develoop coping skills, etc.



However, as a researcher into the social/historical topic of disability, I've found that the psychological/psychiatric approach has its limits--it may be very good at helping cients cope--but the practioners often have virtually no real understanding of what a person with a disability--any disability--has to cope WITH.



For example, a person with a disability may have trouble establishing/engaging in interactions with others--and hence s isolated. The mental health approach is to help the client improve social/communication skills, overcome anxiety, etc.



All to often that paradigm does not take into account the discrimination and ill-treatment our society directs toward people with disabilities. Nor the physical limitations (e.g., people who suffer mobility or vision impairments often are socially isolated because they CAN'T readily get out to interact with others).



So--specific suggestion: do some related reading in the field of "disability studies." That s the search term I'd start with. This is not special ed, or (except incidentally) psychology--it is focused on the social roles, status, and experiences of people with disabilities. Here's a few titles to look for (not full citations; I don't have a biblio handy--sorry. But you'll have no trouble finding these)



No Pity

Nothing About Us Without Us

The Disability Studies Reader

The New Disability HIstory

Claiming Disability (Litton)

Freakery (Garland-Thompson)

Forbidden Signs (Baynton)

The Disability Studies Handbook (a must--but find a library with a copy; the thing costs around $150)

The disabled Veteran in History (Gerber)



Do google searches ( or on Amazon) and you'l pick up plenty of other titles. I f you have questions, check my profile page--you can e-mail me from there.

Answer 3

Keep in mind that every client of yours is first of all a person and an individual. NExt, dont forget that every injury effects teh clients differently. Therefore, Tx needs to be taylored to each person individually although group activities may deal with some of the more common problems. And last, think outside the box and make Tx fun. And remember that in some cases stimulation can lead to adaptation and new pathways in the brain.

Answer 4

Hi! Thanks for the question. I have a brain injury and it's good to see there are people out there who are interested specifically in helping us.



My best advice is to read everything you can about brain injuries and their effects before you begin. Remember that although there may be "typical" effects, everyone is different and you will have to adapt your therapy for each patient. Below I've cut and pasted some helpful info from Wikipedia about the emotional effects of brain injury. I think it's pretty good -







TBI patients have been described as the "walking wounded" owing to psychological problems. Most TBI patients have emotional or behavioral problems that fit under the broad category of psychiatric health. Family members of TBI patients often find that personality changes and behavioral problems are the most difficult disabilities to handle. Psychiatric problems that may surface include depression, apathy, anxiety, irritability, anger, paranoia, confusion, frustration, agitation, insomnia or other sleep problems, and mood swings. Problem behaviors may include aggression and violence, impulsivity, disinhibition, acting out, noncompliance, social inappropriateness, emotional outbursts, childish behavior, impaired self-control, impaired self-awareness, inability to take responsibility or accept criticism, egocentrism, inappropriate sexual activity, and alcohol or drug abuse or addiction. Some patients' personality problems may be so severe that they are diagnosed with organic personality disorder, a psychiatric condition characterized by many of the problems mentioned above. Sometimes TBI patients suffer from developmental stagnation, meaning that they fail to mature emotionally, socially, or psychologically after the trauma. This is a serious problem for children and young adults who suffer from a TBI. Attitudes and behaviors that are appropriate for a child or teenager become inappropriate in adulthood. Many TBI patients who show psychiatric or behavioral problems can be helped with medication and psychotherapy, although the effectiveness of psychotherapy may be limited by the residual neurocognitive impairment. Technological improvements and excellent emergency care have diminished the incidence of devastating TBI while increasing the numbers of patients with mild or moderate TBI. Such patients are more adversely affected by their emotional problems than by their residual physical disabilities.

Answer 5

Mary;



Some very good answers so far. I agree with almost all of them. There are many resources out there - actually too many as it is impossible to read and evaluate them - to help you. I am a former engineer, aerospace worker, university professor/researcher, & pilot who learned about brain injury after being run over by a truck that left the road and hit me at 55 mph while I was a pedestrian. I had virtually every possible cognitive and emotional problem - but I could still read (may not remember for long) and could "make sense of things" (attributed to my engineering/research background). I realized fairly early how lucky I was (to survive, to have insurance and disability, and previous life exeriences to help me in rehab). I taught a math class for brain injured survivors at a community college, then spent about a year traveling to seminars on rehab, brain insults, spirituality and "winning". I was trying to see how I could help others in ways I was not helped because, despite spend a lot of money to see many therapists, I was told many silly things regarding brain injury and rehabilitation. I then returned to University, taking 64 units of graduate psychology and rehab counseling. After graduation I counseled at a neuropsych group dealing with brain injury, PTSD and abuse. Then went to state brain injury association to help more folks. I have since consulted for the state & US governments and regularly travel the US and overseas to help educate about brain injury - at no cost. Email me for more information if you wish.



Important Reminders as a Therapist:



Never discount what the client is saying - there may be important points in there that they are not stating clearly or you may not appreciate.



Try not to apply your "normal thinking" to their situation - most "common knowledge" or even "professional knowledge" about brain injury is often flawed or incorrect.



Be aware of lighting, noise and distractions. Many people are very affected by these post-injury.



Stress (stressors) are extremely detremental post-injury. Many of these come from internal expections and beliefs of the survivor and family/caregivers. You must educate everyone to minimize these effects.



Never, repear NEVER say that you understand what they are going through. You may be sympathetic but you (or anyone else) will never know what it is like unless you have been there - even then there are many differences in the paths people take. Saying that is as crazy as my saying as a male that I know exactly what it is like to be pregnant and have a baby - no way.



It is very good that you are going into that field. It is often a difficult and long, uneven road with clients but the world certainly needs more folks like you. Please do not take any of the above comments as negative or discouraging. Best of luck in your career.

Answer 6

contact you local university and the department you need. thats a good start, my husband had a head injury and is on alot of meds and he goes to our local university and talks to his therapist there he has given him some very good books to read .

hope i've helped some, good luck!

Rosey

Answer 7

Be truthful, honest, try not to be patronizing,

but really, each individual has individual needs. Get to know them personally and figure them out. I hope you have a great career!