 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

Bobbie, Caroline, Jason and Jo

 Complexity of traumatic brain injury – psychological, social, financial, behavioural, relational, yadiyadiyada

INTRODUCTORY AND DEFINITIONS

 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) YooC&printsec=frontcover&source=gbs_ge_summary_r&ca d=0#v=onepage&q&f=false Traumatic (acquired) brain injury and behavioural difficulties YooC&printsec=frontcover&source=gbs_ge_summary_r&ca d=0#v=onepage&q&f=false

 Types of injury  Neuroanatomy  Associated difficulties

 Confusion over terminology  Complexity of neuro understanding

IMPACTS

 “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

 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)

ROLE OF PSYCHOLOGY (WHAT CAN BE DONE?)

 Assessment  Formulation  Intervention etc……………..

 Brain Injury Association of America Brain Injury Association of America  National Institute of Neurological Disorders and Stroke (NINDS) National Institute of Neurological Disorders and Stroke (NINDS)  Brain Injury Association of Canada Brain Injury Association of Canada  Brain Injury Association of Queensland Australia Brain Injury Association of Queensland Australia  Headway - the brain injury association Headway - the brain injury association  Ontario Shores Centre for Mental Health Sciences Ontario Shores Centre for Mental Health Sciences  Ontario Brain Injury Association Ontario Brain Injury Association  NICE guidelines, but only for Triage, assessment, investigation and early management of head injury in infants, children and adults  Rehabilitation following acquired brain injury National clinical guidelines - by Royal College of physicians ad647dbdbd38.pdf ad647dbdbd38.pdf ◦ Included recommendation for clinical psychology provision! per of population (pg18)  More British ones - found Headway

 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)

 Jo

 Increase in traumatic brain injuries in veterans returning from war ◦ America, rehab, v pricey

 Who has overall clinical responsibility?

 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?

Questions

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, 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),