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Understanding and Analysis relevant psychological theories and models
demonstrate your application of relevant psychological theory and models in the clinical or organisational context
respond appropriately to ethical issues synthesise national policy and guidance
with the clinical material
Relevant Psychological Theory
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Challenges of working with a traumatic frontal lobe
brain injuryBobbie, Caroline, Jason and Jo
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Complexity of traumatic brain injury – psychological, social, financial, behavioural, relational, yadiyadiyada
Content
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INTRODUCTORY AND DEFINITIONS
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Definition ‘Complex needs refer to multiple interlocking needs that
span health and social issues’. For the DCS component of this assessment, you will be required to demonstrate your application of relevant psychological theory and models in the clinical or organisational context, respond appropriately to ethical issues and synthesise national policy and guidance with the clinical material.Google books has latest edition of the Textbook of Traumatic Brain injury (APA, 2011)http://books.google.co.uk/books?id=N_lVQ7Z-YooC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false
Traumatic (acquired) brain injury and behavioural difficulties
Traumatic Brain Injury
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Epidemiology
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Types of injury Neuroanatomy Associated difficulties
Frontal lobe specific stuff
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Confusion over terminology Complexity of neuro understanding
Critique
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IMPACTS
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“Coping refers to the persons’ cognitive and behavioural efforts to manage (reduce, minimise, master or tolerate) the internal and external demands of the person-environment transaction that is appraised as taxing or exceeding the person’s resources.”◦ Folkman, Lazarus, Gruen & DeLongis (1986, pg. 572)
Direct result of the structural lesion Psychological reaction to the lesion
◦ Somatising Evidence for both
Emotional Impact
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Behavioural difficulties associated with frontal lobe injury impact
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CBT for loss/grief◦ Loss of future prospects, adjusting to irreversible
nature of impairments etc. Anxiety and depression
Theories of hopeless and helplessness depression
Adjustment disorders◦ Many patients suffer poor psychosocial adjustment
and experience a reduced quality of life Wolters et al. (2010)
◦ Effectiveness of psychotherapy and adjustment Ratzel-kurzdorfer, Franke & Wolfersdorf (2003) Strain & Newcorn (2006)
Theoretical Stance
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ROLE OF PSYCHOLOGY (WHAT CAN BE DONE?)
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Assessment Formulation Intervention etc……………..
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Brain Injury Association of America National Institute of Neurological Disorders and Stroke (NINDS) Brain Injury Association of Canada Brain Injury Association of Queensland Australia Headway - the brain injury association Ontario Shores Centre for Mental Health Sciences Ontario Brain Injury Association NICE guidelines, but only for Triage, assessment, investigation and early
management of head injury in infants, children and adults http://www.nice.org.uk/nicemedia/live/11836/36260/36260.pdf
Rehabilitation following acquired brain injury National clinical guidelines - by Royal College of physicianshttp://bookshop.rcplondon.ac.uk/contents/43986815-4109-4d28-8ce5-ad647dbdbd38.pdf ◦ Included recommendation for clinical psychology provision! per 500000 of population (pg18)
More British ones - found Headwayhttp://www.headway.org.uk/home.aspx
National Policy and guidance
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Teaching the patient and family to adapt their lifestyle
Taking into account the severity of cognitive and behavioural problems
Patient being stimulated to learn new skills and compensatory strategies
To return to activities of daily life and participate in society ◦ Wilson (2000)
Aims of cognitive rehabilitation
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Jo
Group work
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Systemic issues
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Increase in traumatic brain injuries in veterans returning from war◦ America, rehab, v pricey
Current issues
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Issues of ethics and capacity
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Who has overall clinical responsibility?
Critique
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Summary
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What would be different if it was an organically caused brain injury?
Impact on client, carer, wider system, CP
What issues would be unique to TBI?
How would impact of CP differ?
Discussion Points
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Questions
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Folkman, S. Lazarus, R. S., Gruen, R. J. & DeLongis, A. (1986) Appraisal, coping, health status and psychological symptoms. Journal of Personality and Social Psychology, 50, 571-579.
Wolters, G., Stapert, S., Brands, I. & Van Heugten, C. (2010) Coping styles in relation to cognitive rehabilitation and quality of life after brain injury in neuropsychological rehabilitation 20(4), 587-600.
References