The Things that Help, the Things that Get in the Way: Working Together to Improve Outcome Following Acquired Brain Injury

Abstract

Working in neurological rehabilitation brings with it numerous opportunities to gain an understanding of the factors that contribute to shaping meaningful living and wellbeing for those tackling the major life changes encountered following acquired brain injury (ABI). These opportunities come in many forms: challenging and brave clients, wise and worrying families, questioning and inspiring colleagues, empowering and limiting work environments and rigid and advancing policy and legislative contexts.Our personal and collective understanding ofthe things that helpandthe things that get in the wayof effective rehabilitation continuously emerges from the convergence of the experience and knowledge afforded by these opportunities. The aim of this paper is to considerthe things that helpandthe things that get in the wayas they have been identified by people with ABI, their families and those who work with them and have been further evidenced through research targeted towards improving short, medium and long-term outcomes for those living with the consequences of ABI. Thesethingsas discussed in this paper capture the essential role of the self, the importance of rights and access to rehabilitation, the impact of the family and the contribution of social connection.

Rehabilitation professionals’ views on social media use in traumatic brain injury rehabilitation: gatekeepers to participation

“…Rehabilitation services aim to assist individuals with traumatic brain injury (TBI) to return to meaningful participation in life and society [1], with the treating team providing interventions and supports to help people to regain their skills and autonomy [2]. Interventions targeting social communication need to take the individual's communicative environments into account and consider how they participate in them.…”

“…People with TBI and rehabilitation professionals may differ in terms of their personalities and their concept of meaningful activities, creating a 'potential mismatch' that impedes rehabilitation [23]. The mismatch between people with TBI and their rehabilitation professionals can result in people with TBI having reduced access to services, particularly as their personality changes, defiant behaviour, and reduced participation in therapy activities may be perceived as noncompliance in more traditional models of rehabilitation [1,23]. In order to counteract the effects of any such mismatch, it is important for collaborative goal setting to occur for people with TBI to build their social networks and participate through meaningful goals successfully [1].…”

“…The mismatch between people with TBI and their rehabilitation professionals can result in people with TBI having reduced access to services, particularly as their personality changes, defiant behaviour, and reduced participation in therapy activities may be perceived as noncompliance in more traditional models of rehabilitation [1,23]. In order to counteract the effects of any such mismatch, it is important for collaborative goal setting to occur for people with TBI to build their social networks and participate through meaningful goals successfully [1]. An understanding of the views of rehabilitation professionals is needed to identify their views on barriers relating to the use of social media in rehabilitation, and facilitators for creating collaborative social media goals with adults with TBI.…”

Finding Goal Focus With People With Severe Traumatic Brain Injury in a Person-Centered Multi-Component Community Connection Program (M-ComConnect)

“…Many researchers, clinicians and people with TBI view community integration and social connection as the ultimate goal of rehabilitation (2,(45)(46)(47)(48)) and yet there is little research looking at how to find activities and interventions that support community integration. The overall aim of the M-ComConnect project was to support people with severe TBI to participate in social leisure/recreation activities that enhanced social connection and integration into their community.…”

Optimizing our evidence map for cognitive–communication interventions: How it can guide us to better outcomes for adults living with acquired brain injury

“…Speech and language therapists (SLTs) share a collective goal of ensuring that those with ABI‐related CCD are provided with optimal and timely interventions to attain their highest level of participation and satisfaction in family, community, social, work and academic communications (Togher et al., 2014; Douglas, 2018). Central to the achievement of this goal is the translation of evidence to determine ‘optimal interventions’ and the ability to address barriers to their implementation.…”