THE ROLE OF LOGIC, PLAY, AND STORYTELLING WHEN COUNSELING PERSONS WITH BRAIN INJURY

GLASCOW COMA SCALE FOR TBI MILD: GCS 13-15 MODERATE: GCS = 9-12 SEVERE: GCS = 8 or LESS *Level of consciousness is based on eye, verbal, and motor function responses Handouts describe GCS rating scale for level of consciousness and severity of TBI

WHY USE LOGIC, PLAY, AND STORYTELLING? EXECUTIVE FUNCTION ISSUES DEPRESSION ANXIETY CO-OCCURING DISORDERS MEMORY PROBLEMS RELATIONAL PROBLEMS ANGER LOSS OF IDENTITY

LOGIC OF REPETITION AND CUEING WORKS TO IMPROVE EPISODIC MEMORY WORKS TO IMPROVE PROSPECTIVE MEMORY ALSO, THE CLIENT CAN ALTER THEIR HOME ENVIRONMENT WHICH CAN PROMPT THEM TO REMEMBER CERTAIN IMPORTANT TASKS.

HELPFUL CBT TECHNIQUES Identify triggers Dispute negative thoughts Structure daily activities Be proactive with difficult events/situations Identify goals

METRONOME Metronome therapy can be very helpful to assist the patient/client with divided attention issues, as it works to change the brain networks related to rhythm and timing in the brain.

INTERACTIVE METRONOME THERAPY IM THERAPY CAN IMPROVE THESE FUNCTIONS: ATTENTION/CONCENTRATION PROCESSING SPEED WORKING MEMORY EXECUTIVE FUNCTIONS SPEECH AND LANGUAGE SKILLS SOCIAL SKILLS ACTIVITIES OF DAILY LIVING IM is an evidence-based tool which is known to be assistive to persons with ADHD, Traumatic Brain Injury, Schizophrenia, and Learning Disabilities

PLAYTIME CARDS PUZZLES BOARD GAMES

PLAY AS COGNITIVE REHABILITATION ASSISTS IN: DECISION MAKING PLANNING JUDGMENT IMPULSIVITY RELAXATION

MUSIC ARTWORK Did you know that someone who may have aphasia(inability to express or understand speech) can probably sing an entire song? If the person received a stroke or traumatic brain injury on the left side of the brain can still sing, because music is processed in the right side of the brain. Artwork can be extremely therapeutic for someone who has endured a brain injury. Sculpting, or any art using the hands utilizes many functions

STORYTELLING A brain injury can either suddenly or slowly erode a person’s former identity. Narrative therapy can allow the individual to explore the essence of their current identity through story. This can be a significant empowering therapeutic technique for persons who have endured a brain injury.

OF STORYTELLING Increases Oxytocin in the brain SOME POTENTIAL BENEFITS OF STORYTELLING Increases Oxytocin in the brain Engages clients cognitively and affectively Can increase problem-solving skills Can facilitate hopefulness in difficult situations

THOUGHT TO PONDER “GIANTS ARE NOT WHAT WE THINK THEY ARE. THE SAME QUALITIES THAT APPEAR TO GIVE THEM STRENGTH ARE OFTEN THE SOURCES OF GREAT WEAKNESS.” Malcolm Gladwell, “David and Goliath”.

TIPS TO ENHANCE THERAPEUTIC SESSIONS Morning appointments Comfortable seating No bright lights or loud noises Direct questions and answers Be on time

HELPFUL STRATEGIES FOR UNIQUE ISSUES BEING MINDFUL OF EXTERNAL STIMULI SUCH AS BRIGHT LIGHT, LOUD NOISES, LARGE CROWDS, ETC. VISUAL DETAILED LISTS FOR TASKS REMINDERS SUCH AS MEMORY NOTEBOOKS, POST-IT NOTES DETAILED EXPLANATIONS OF AN EVENT PRIOR TO ITS OCCURRENCE PUZZLES AND GAMES WHICH ENHANCE PLANNING AND PROBLEM SOLVING SKILLS

INDIVIDUAL AND GROUP THERAPY A COMBINATION OF BOTH INDIVIDUAL AND GROUP THERAPIES MAY BENEFIT MILD TO MODERATE BRAIN INJURED PERSONS IN THE MOST EFFICACIOUS MANNER OFTENTIMES PEOPLE WITH SEVERE BRAIN INJURIES RECEIVE THE HIGHEST QUALITY OF COUNSELING CARE BY ATTENDING INTENSE OUTPATIENT GROUP THERAPY AND INDIVIDUAL BEHAVIORAL OR COGNITIVE BEHAVIORAL THERAPY

TRAUMATIC BRAIN INJURY QUESTIONNAIRE PAST INJURY: HAVE YOU EVER HAD AN INJURY TO YOUR HEAD OR FACE? LOSS OF CONSCIOUSNESS: HAVE YOU EVER LOST CONSCIOUSNESS? BEHAVIOR: HAS THERE BEEN A CHANGE IN YOUR BEHAVIOR? EXECUTIVE FUNCTIONING: ARE YOU HAVING DIFFICULTY CONCENTRATING, ORGANIZING THOUGHTS, OR REMEMBERING?

RESOURCES The Essential Brain Injury Guide (5th ed.). (2016). USA: Brain Injury Association of America. Brainline.org. Julia Johnson, LPC, MHSP, CBIS, CRC Licensed Professional Counselor, Certified Brain Injury Specialist, Certified Rehabilitation Counselor