Effective Services for People Living with Brain Injury

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1 Effective Services for People Living with Brain Injury Jean Capler, MSW, LCSW Local Support Network Leader The Rehabilitation Hospital of Indiana Resource Facilitation Plan for Today Brain Injury 101 Challenges for people with Brain injury Effective services for people with BI Social Support Systems 2 1

2 Acquired Brain Injury Brain Injuries Traumatic brain injuries (TBI) Force causing injury Falls Vehicle accidents Hit on the head by an object piercing/contusion Assaults Blast injuries Acquired Brain Injuries Other types not TBI Stroke Aneurysm Tumor Anoxia Disease process 2

3 Common Effects of Brain Injury Cognitive Short term memory loss Slowed processing speed Attention & concentration Executive functions Common Effects of Brain Injury Physical Seizures Headaches Fatigue Sleep disturbance Balance problems Speech & vision problems 3

4 Common Effects of Brain Injury Emotional Anxiety & depression Impulsivity Mood swings Agitation Egocentric behaviors (difficulty seeing how behaviors can affect others) Every Brain Injury is Unique What type of brain injury? What part of the brain is injured? Who s brain is it in? How did their brain work before? Support system before? Prior complications 4

5 Populations at Risk of BI People with addiction issues People in domestic violence situations People in the criminal justice system Athletes Males Mental health population may develop depression, anxiety, PTSD after the brain injury (up to 60% of TBI population has depression) Undiagnosed Brain Injury You just had a concussion Never went to the doctor Other injuries distract Important to ASK! Have you ever hit your head or been knocked unconscious or dazed? 5

6 Challenges in Working with Someone with a BI Problems in participation/follow through Retention of what you covered Comprehension & Expression Attendance Recall of situations of concern Sometimes practical issues: transportation Common Issues in Psychotherapy Depression, anxiety, PTSD Emotion regulation Grief Changed roles Self esteem Adjustments Re-entry into family, work, society 6

7 Tips for Working w/clients with BI Write things down Keep verbal communication direct & to the point Encourage use of day planner, notebooks, calendars, electronic reminders Repeat, review, rehearse Provide direct feedback re: inappropriate behavior Tips Redirect tangential or excessive speech Use concrete examples Paraphrase concepts Provide appropriate accommodations Understand client lack of awareness (may not be denial) Doubly important to not be reactive Coordinate with other providers & supports 7

8 SOCIAL SUPPORT SYSTEMS Acute Care Return to Life 8

9 Supports to Bridge That Gap Outpatient Therapies PT/OT/ST/Cognitive Rehab/Psychotherapy Employment Supports Vocational Rehabilitation Employment Services Resource Facilitation $$ for Other Support Services TBI Waiver/BDDS Waiver Resource Facilitation Specialized case management for people with brain injuries who have a return to work or return to school goal Assists with access to services & supports Coordination among those services & supports Provide education on BI and resources Provided by a team of brain injury specialists Funded by Vocational Rehab 9

10 Eligibility for Resource Facilitation Acquired non-progressive brain injury Goal of return to competitive employment or school that will lead to competitive employment 19 Resource Facilitation Results Randomized Controlled Trial most recent 68% of the RF group was employed or enrolled in school at the end of treatment compared to 55% of the control group Replicated in 3 different studies 20 10

11 How to Refer to RF Contact your Local Support Network Leader Jean Capler Great Websites To Learn More

12 Thank you! 23 12

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