How does a narrative understanding of change in families post brain injury help us to humanise our professional practice?

2021 ◽  
pp. 1-9
Author(s):  
Charlotte J Whiffin ◽  
Caroline Ellis-Hill

Abstract In this paper, we critically explore the discourse of change post brain injury and challenge the dominant discourse of negative change, which alone leaves little room for other perspectives to exist. These negative changes pose a considerable risk to the well-being of families who may benefit from engaging in richer accounts making room for a more coherent and connected sense of self and family post-injury. We explore how narrative approaches provide opportunities for all practitioners to expand their professional scripts and support families to move towards a future which is not dominated by a discourse of loss. While loss and negative change is an important and very real consequence, of brain injury, focusing purely on stories of loss is life limiting for family members and can cause psychological distress. The life thread model is offered as a visible tool for all practitioners to engage with and use while working with families, providing a concrete focus for reflection and discussion of narratives relating to change which otherwise can feel quite abstract in everyday practice. We argue that one way we can humanise our professional practice is to support all practitioners to engage in a narrative understanding of family change following ABI.

2022 ◽  
Author(s):  
Siobhán M Griffin ◽  
Elaine Kinsella ◽  
Daragh Bradshaw ◽  
Grace McMahon ◽  
Alastair Nightingale ◽  
...  

Predicting positive psychosocial outcomes following an Acquired Brain Injury (ABI) remains a challenge. Considerable research demonstrates that social group memberships can have positive effects on psychological well-being, particularly during life transitions. Social group memberships are argued to help people derive a sense of self. This prospective study examined if social group memberships (number of groups and connectedness with groups) could predict posttraumatic growth (PTG) in those affected by ABI. Thirty-six participants (10 females, Mage = 46.56, SD = 11.46) engaged in community rehabilitation services completed measures at two time-points. Mediation analyses demonstrated that the number of new group memberships (groups formed post-injury) predicted greater PTG at time 2, via stronger connectedness with these new group memberships (controlling for initial PTG). The observed results suggest that a focus on developing and strengthening connections with new group memberships may promote positive adjustment after brain injury.


2019 ◽  
Vol 34 (7) ◽  
pp. 1165-1174
Author(s):  
Evan Zahniser ◽  
Nancy R Temkin ◽  
Joan Machamer ◽  
Jason Barber ◽  
Geoffrey T Manley ◽  
...  

Abstract Objective The Functional Status Examination (FSE) is a comprehensive measure of functional status post-traumatic brain injury (TBI) that has primarily been used in studies of moderate-to-severe TBI. The present observational study examines functional status using the FSE among patients who sustained mild TBIs (mTBIs; defined as Glasgow Coma Scale [GCS] = 13–15 at admission) seen in a Level 1 trauma center. Study aims included examining the course of functional status following mTBI, as well as exploring relationships of the FSE and other relevant constructs among those with GCS = 13–15. Method Participants were assessed at 2 weeks (n = 112), 3 months (n = 113), 6 months (n = 106), and 12 months (n = 88) post-injury for changes in functional status resulting both (a) from all injuries and (b) from TBI only. Results Among seven domains of day-to-day functioning, participants generally experienced the greatest disruption in their primary activity (work or school) and in leisure and recreation. Subjects’ overall functional status tended to improve over time, with sharpest increases in functionality occurring in the first 3 months post-injury. However, some subjects continued to report functional limitations even at 12 months post-injury. Functional status was largely unrelated to neurocognitive functioning, but related strongly to post-traumatic symptoms, life satisfaction, and emotional well-being, particularly at 3 months post-injury and beyond. Conclusion Findings indicate that functional impairments related to mTBI may be more likely to persist than widely believed, with those who experience lingering functional deficits at particular risk for emotional health difficulties.


2021 ◽  
Vol 12 ◽  
Author(s):  
Christin Camia ◽  
Rida Zafar

Forced migration changes people’s lives and their sense of self-continuity fundamentally. One memory-based mechanism to protect the sense of self-continuity and psychological well-being is autobiographical meaning making, enabling individuals to explain change in personality and life by connecting personal experiences and other distant parts of life to the self and its development. Aiming to replicate and extend prior research, the current study investigated whether autobiographical meaning making has the potential to support the sense of self-continuity in refugees. We therefore collected life narratives from 31 refugees that were coded for autobiographical reasoning, self-event connections, and global narrative coherence. In line with prior research, results suggest that autobiographical meaning making relates to a higher sense of self-continuity and less psychological distress. Yet, if refugees experienced many continuing postdisplacement stressors in addition to their forced displacement, autobiographical meaning making was associated with higher self-discontinuity and greater psychological distress, especially with trauma-related symptoms such as memory intrusion and hyperarousal. Altogether, results indicate that autobiographical meaning making helps to compensate the effects of extreme biographical disruptions on the sense of self-continuity, as long as the stress caused by the biographical change is not overwhelming or too protracted.


2020 ◽  
Vol 5 (1) ◽  
pp. 88-96
Author(s):  
Mary R. T. Kennedy

Purpose The purpose of this clinical focus article is to provide speech-language pathologists with a brief update of the evidence that provides possible explanations for our experiences while coaching college students with traumatic brain injury (TBI). Method The narrative text provides readers with lessons we learned as speech-language pathologists functioning as cognitive coaches to college students with TBI. This is not meant to be an exhaustive list, but rather to consider the recent scientific evidence that will help our understanding of how best to coach these college students. Conclusion Four lessons are described. Lesson 1 focuses on the value of self-reported responses to surveys, questionnaires, and interviews. Lesson 2 addresses the use of immediate/proximal goals as leverage for students to update their sense of self and how their abilities and disabilities may alter their more distal goals. Lesson 3 reminds us that teamwork is necessary to address the complex issues facing these students, which include their developmental stage, the sudden onset of trauma to the brain, and having to navigate going to college with a TBI. Lesson 4 focuses on the need for college students with TBI to learn how to self-advocate with instructors, family, and peers.


2020 ◽  
Vol 51 (3) ◽  
pp. 171-182
Author(s):  
Allard R. Feddes ◽  
Kai J. Jonas

Abstract. LGBT-related hate crime is a conscious act of aggression against an LGBT citizen. The present research investigates associations between hate crime, psychological well-being, trust in the police and intentions to report future experiences of hate crime. A survey study was conducted among 391 LGBT respondents in the Netherlands. Sixteen percent experienced hate crime in the 12 months prior. Compared to non-victims, victims had significant lower psychological well-being, lower trust in the police and lower intentions to report future hate crime. Hate crime experience and lower psychological well-being were associated with lower reporting intentions through lower trust in the police. Helping hate crime victims cope with psychological distress in combination with building trust in the police could positively influence future reporting.


2014 ◽  
Author(s):  
Alison A. Fedio ◽  
James Sexton ◽  
Larisa Lasko ◽  
Simona Efanov ◽  
Stephanie Golden ◽  
...  

2010 ◽  
Author(s):  
Paul C. Hubbarth ◽  
Lisa J. Rapport ◽  
Brigid Waldron-Perrine ◽  
Sarah-Jane Meachen

2010 ◽  
Vol 30 (3) ◽  
pp. 148-149 ◽  
Author(s):  
J. Caron ◽  
A. Liu

Objective This descriptive study compares rates of high psychological distress and mental disorders between low-income and non-low-income populations in Canada. Methods Data were collected through the Canadian Community Health Survey – Mental Health and Well-being (CCHS 1.2), which surveyed 36 984 Canadians aged 15 or over; 17.9% (n = 6620) was classified within the low-income population using the Low Income Measure. The K-10 was used to measure psychological distress and the CIDI for assessing mental disorders. Results One out of 5 Canadians reported high psychological distress, and 1 out of 10 reported at least one of the five mental disorders surveyed or substance abuse. Women, single, separated or divorced respondents, non-immigrants and Aboriginal Canadians were more likely to report suffering from psychological distress or from mental disorders and substance abuse. Rates of reported psychological distress and of mental disorders and substance abuse were much higher in low-income populations, and these differences were statistically consistent in most of the sociodemographic strata. Conclusion This study helps determine the vulnerable groups in mental health for which prevention and promotion programs could be designed.


2020 ◽  
Author(s):  
Julia Hegy ◽  
Noemi Anja Brog ◽  
Thomas Berger ◽  
Hansjoerg Znoj

BACKGROUND Accidents and the resulting injuries are one of the world’s biggest health care issues often causing long-term effects on psychological and physical health. With regard to psychological consequences, accidents can cause a wide range of burdens including adjustment problems. Although adjustment problems are among the most frequent mental health problems, there are few specific interventions available. The newly developed program SelFIT aims to remedy this situation by offering a low-threshold web-based self-help intervention for psychological distress after an accident. OBJECTIVE The overall aim is to evaluate the efficacy and cost-effectiveness of the SelFIT program plus care as usual (CAU) compared to only care as usual. Furthermore, the program’s user friendliness, acceptance and adherence are assessed. We expect that the use of SelFIT is associated with a greater reduction in psychological distress, greater improvement in mental and physical well-being, and greater cost-effectiveness compared to CAU. METHODS Adults (n=240) showing adjustment problems due to an accident they experienced between 2 weeks and 2 years before entering the study will be randomized. Participants in the intervention group receive direct access to SelFIT. The control group receives access to the program after 12 weeks. There are 6 measurement points for both groups (baseline as well as after 4, 8, 12, 24 and 36 weeks). The main outcome is a reduction in anxiety, depression and stress symptoms that indicate adjustment problems. Secondary outcomes include well-being, optimism, embitterment, self-esteem, self-efficacy, emotion regulation, pain, costs of health care consumption and productivity loss as well as the program’s adherence, acceptance and user-friendliness. RESULTS Recruitment started in December 2019 and is ongoing. CONCLUSIONS To the best of our knowledge, this is the first study examining a web-based self-help program designed to treat adjustment problems resulting from an accident. If effective, the program could complement the still limited offer of secondary and tertiary psychological prevention after an accident. CLINICALTRIAL ClinicalTrials.gov NCT03785912; https://clinicaltrials.gov/ct2/show/NCT03785912?cond=NCT03785912&draw=2&rank=1


Author(s):  
Virginia L. Warren

This chapter explores the concept of moral disability, identifying two types. The first type involves disabling conditions that distort one’s process of moral reflection. Examples include the incapacity to consider the long-term future, to feel empathy for others, and to be honest with oneself. A noteworthy example of self-deception is systematically denying one’s own—and humanity’s—vulnerability to the power of others, to accidents, and to having one’s well-being linked to that of others and the eco-system. Acknowledging vulnerability often requires a new sense of self. The second type includes incapacities directly resulting from ‘moral injury’—debilitating, self-inflicted harms when one violates a deeply held moral conviction, even if trying to remain true to another moral value. Examining moral disabilities highlights the moral importance of self-identity. More progress may be made on controversial issues if we discuss who we are, how we connect, and how we can heal.


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