1. Improving Psychosocial Function in Adults with Brain Injury Liz Walton, OTS Spalding University January 24 th, 2014

2. Brain Injury –The Silent Epidemic http://www.youtube.com/watch?v=Wo4Nq3S7Bns

3. Causes of Brain Injury

4. Brain Injury Statistics More than 5 million people in the US are living with the after effects of brain injury - CDC About 1.7 million people receive a brain injury every year – CDC An estimated 214,000 Kentucky Residents have a brain injury – Brain Injury Association of Kentucky

5. Brain Injury Statistics Brain injury is costly. A severe brain injury is estimated to cost between $4 - 7 million dollars over the lifetime of the individual – Brain Injury Association of Kentucky The cost of treating, rehabilitating and caring for the victims of TBI costs the U.S. $30 billion each year -C ENTER FOR B RAIN I NJURY AND R EPAIR, University of Pennsylvania A person with a brain injury is 7 times more likely to wind up in prison than those without a brain injury – Brain Injury Association of Kentucky

6. Psychosocial Function – What does that mean? Emotional stability and regulation Social skills Coping skills Behavioral regulation Sense of self efficacy Communication skills Community participation Social integration

8. Why is this important? Dysfunction in these areas can disrupt all other therapeutic interventions Isolation

9. Research All articles were from no earlier than 2007 and were published in scholarly peer reviewed journals Databases: Academic Search Premier CINAHL Medline OT Search World CAT

10. Journals OTJR: Occupation, Participation and Health Brain Injury Disability and Rehabilitation Archives of Physical Medicine and Rehabilitation Clinical Rehabilitation

11. Level of Evidence: Level I – 3 articles Level II – 3 articles Level III – 2 articles

12. Themes found during research: Group sessions Interdisciplinary approach Family/caregiver participation in therapy

13. Group Sessions Education about brain injury and recovery Peer discussions with feedback Coping skills training – workbooks and discussion Coaching and feedback about how to handle challenging situations Individualized goal setting with input from peers The awareness that one is not alone Self awareness Stress management techniques Promotion of interaction

14. Interdisciplinary Approach OT PT SLP Psychologists Social workers Coaches

15. Family/Caregiver Involvement Participation in individual and group sessions Education and support

16. The Road Forward… Implement evidence based practice Advocate for the role of OT in BI rehabilitation

17. The Road Forward… Further research needed

18. Review Why is it important to address psychosocial function? What were the 3 prevailing themes found? How can you implement these findings into your practice?

19. Scott DeBurger, OTR/L – Baptist Health La Grange Joanne Ehrman, OTR/L - Neurorestorative Staff at Neurorestorative Clients for sharing and allowing me to learn from their experiences

20. Questions?

21. Liz Walton, OTS LizWalton21@gmail.com REFERENCES Backhaus, S., Ibarra, S., Klyce, D., Trexler, L., & Malec, J. (2010). Brain injury coping skills group: A preventative intervention for patients with brain injury and their caregivers. Archives of Physical Medicine and Rehabilitation, 91(6), 840-848. doi: http://dx.doi.org/10.1016/j.apmr.2010.03.015http://dx.doi.org/10.1016/j.apmr.2010.03.015 Blake, H. (2009). Exercise intervention in brain injury: A pilot randomized study of tai chi qigong. Clinical Rehabilitation, 23(1), 589-598. doi: 10.1177/0269215508101736 Dahlberg, C. A., Cusick, C. P., Hawley, L. A., Newman, J. K., Morey, C. E., Harrison-Felix, C. L., & Whitenect, G. G. (2007). Treatment efficacy of social communication skills training after traumatic brain injury: A randomized treatment and deferred treatment controlled trial. Archives of Physical Medicine and Rehabilitation, 88(12), 1561-1573. Doig, E., Fleming, J., Kuipers, P., Cornwell, P., & Khan, A. (2011). Goal directed outpatient rehabilitation following TBI: A pilot study of programme effectiveness and comparison of outcomes in home and day hospital settings. Brain Injury, 25(11), 1114-1125. Fleming, J., Kuipers, P., Foster, M., Smith, S., & Doig, E. (2009). Evaluation of an outpatient, peer group intervention for people with acquired brain injury based on the icf ‘environment’ dimension. Disability and Rehabilitation, 31(20), 1666-1675. doi: 10.1080/09638280902738425

22. Liz Walton, OTS LizWalton21@gmail.com REFERENCES Geurtsen, G. J., Martina, J. D., Van Heugten, C. M., & Geurts, A. C. H. (2008). A prospective study to evaluate a new residential commnity reintegration programme for severe chronic brain injury: the brain integration programme. Brain Injury, 22(7/8), 545-554. Lundqvist, A., Linnros, H., Orlenius, H., & Samuelsson, K. (2010). Improved self-awareness and coping strategies for patients with acquired brain injury – A group therapy programme. Brain Injury, 24(6), 823-832 Wheeler, S. D., Lane, S. J., & McMahon, B. T. (2007). Community participation and life satisfaction following intensive, community-based rehabilitation using a life skills training approach. OTJR: Occupation, Participation and Health, 27(1), 13- 22. Brain Injury Association of Kentucky C ENTER FOR B RAIN I NJURY AND R EPAIR, University of Pennsylvania Centers for Disease Control and Prevention