What can i do to improve the outcome of my head injured family member?
1. Cognitive Rehabilitation
An index measuring the degree to which head injured survivors were using the compensatory strategies which had been taught in their TBI rehabilitation program was the best predictor of long-term outcome. This finding validates the importance and effectiveness of teaching compensatory mechanisms in rehabilitation programs and suggests that most survivors could benefit from going through programs such as an Outpatient Rehabilitation Program. It has also been found a negative relationship between length of time since discharge from rehabilitation program and compensatory strategy usage, which seems to indicate a need for periodic postprogram follow-up sessions to reinforce the usage of compensatory mechanisms.
2. Family Therapy
Of most importance to the caregivers of TBI survivors however, was that regardless of severity of injury, TBI survivors who were not living with family and had less family involvement were more independent with regard to home responsibilities than survivors with more family involvement. This finding suggests that rehabilitation programs should encourage family members of TBI survivors to carefully review the level of support which they are providing. For instance, they should consider whether and why they may be providing more assistance than is necessary or healthy for the survivors. Optimally, this exploration would take place in a nonconfrontational, therapeutic environment such as a family support group or a family therapy session.. The goals of these sessions should be to help families determine when it may be beneficial to push survivors toward more independent functioning and living, as well as to assist them in understanding the types of support which are most helpful in various situations.
3. Substance Abuse Counseling
Other interesting findings came out this study. Although the survivors denied using marijuana or other illegal drugs, the participants reported significant alcohol usage. This suggests that substance abuse counseling should be a significant focus of rehabilitation efforts.
4. Political Advocacy
Given that these cognitive rehabilitation and family therapy sessions might lead to an increase in referrals to programs which promote independent living for TBI survivors (e.g., transitional housing, independent living centers, supported apartment programs, halfway houses), the importance of allocating government funds for these programs becomes clear. In fact, you may notice that funding for all of the programs which I have suggested is limited at this point. Therefore, I strongly recommend that you get involved with the Brain Injury Association and the other advocacy groups which are listed in our web site and lobby for increased funding for outpatient, community-based programs for TBI survivors.
Corthell, D. W. (1990). Traumatic brain injury and vocational rehabilitation. Menomonee, WI: The Research and Training Center, University of Wisconsin-Stout.
DeBoskey, D. S. (1996). Coming home: A discharge manual for families of persons with a brain injury. Houston, TX HDI Publishers.
Katz, R. A., Kay, T. E., & Keitel, M. A. (1998). The relationships among social support, autonomy, and vocational outcome following a traumatic brain injury. Rehabilitation Psychology 43(2).
Lezak, M. D. (1995). Neuropsychological Assessment (Third Edition). New York: Oxford University Press.
Williams, J. M., & Kay, T. (1991). Head injury: A family matter. Baltimore, MD: Paul H, Brookes Publishing Co.