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

2. 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

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

4. 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.

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

6. 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.

7. 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

8. PLAYTIME
CARDS
PUZZLES
BOARD GAMES

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

10. 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

11. 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.

12. 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

13. 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”.

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

15. 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

16. 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

17. 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?

18. 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