understanding and analysis relevant psychological theories and models demonstrate your application...

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

Relevant Psychological Theory

Challenges of working with a traumatic frontal lobe

brain injuryBobbie, Caroline, Jason and Jo

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

Content

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)http://books.google.co.uk/books?id=N_lVQ7Z-YooC&printsec=frontcover&source=gbs_ge_summary_r&cad=0#v=onepage&q&f=false

Traumatic (acquired) brain injury and behavioural difficulties

Traumatic Brain Injury

Epidemiology

Types of injury Neuroanatomy Associated difficulties

Frontal lobe specific stuff

Confusion over terminology Complexity of neuro understanding

Critique

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

Emotional Impact

Behavioural difficulties associated with frontal lobe injury impact

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)

Theoretical Stance

ROLE OF PSYCHOLOGY (WHAT CAN BE DONE?)

Assessment Formulation Intervention etc……………..

Brain Injury Association of America National Institute of Neurological Disorders and Stroke (NINDS) Brain Injury Association of Canada Brain Injury Association of Queensland Australia Headway - the brain injury association Ontario Shores Centre for Mental Health Sciences Ontario Brain Injury Association NICE guidelines, but only for Triage, assessment, investigation and early

management of head injury in infants, children and adults http://www.nice.org.uk/nicemedia/live/11836/36260/36260.pdf

Rehabilitation following acquired brain injury National clinical guidelines - by Royal College of physicianshttp://bookshop.rcplondon.ac.uk/contents/43986815-4109-4d28-8ce5-ad647dbdbd38.pdf ◦ Included recommendation for clinical psychology provision! per 500000 of population (pg18)

More British ones - found Headwayhttp://www.headway.org.uk/home.aspx

National Policy and guidance

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)

Aims of cognitive rehabilitation

Jo

Group work

Systemic issues

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

Current issues

Issues of ethics and capacity

Who has overall clinical responsibility?

Critique

Summary

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?

Discussion Points

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, 571-579.

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), 587-600.

References