Community-based training after acquired brain injury: preliminary findings

AbstractCommunity-based rehabilitation for people with acquired brain injury (ABI) is largely driven by goals set in the course of rehabilitation by clients and service providers. A preliminary study investigating the perspectives and practice of experienced rehabilitation coordinators was undertaken to explore issues that influence goal-setting in community rehabilitation settings. Detailed interviews and subsequent rounds of clarification were conducted with six experienced rehabilitation coordinators. Key themes identified through inductive analysis include cognitive influences, other client influences, service provider influences and the client-service provider relationship in the goal-setting process. Based on the findings, a preliminary descriptive schema of goal-setting in a community-based rehabilitation service for people with acquired brain injury is suggested. Factors such as training, experience, and values of the rehabilitation coordinators are also discussed in terms of their influence on goal-setting. Some strategies to assist a person with ABI to identify and work towards achieving realistic goals are identified. Suggestions for enhancing community-based rehabilitation practices with people with ABI, and scope for future research are noted. This paper constitutes a general overview of goal-setting in community-based ABI rehabilitation.

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Outcomes of a community-based treatment programme for people with acquired brain injury in the chronic phase: a pilot study

Neuropsychological Rehabilitation ◽

10.1080/09602011.2017.1298527 ◽

2017 ◽

Vol 29 (2) ◽

pp. 305-321 ◽

Cited By ~ 2

Author(s):

Marij Middag-van Spanje ◽

Sanne Smeets ◽

Jolanda van Haastregt ◽

Caroline van Heugten

Keyword(s):

Brain Injury ◽

Pilot Study ◽

Chronic Phase ◽

Acquired Brain Injury ◽

Treatment Programme ◽

Community Based

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Integrated Behavioral Intervention and Person-Centered Therapy Within Community-Based Treatment of an Adult With Acquired Brain Injury

Clinical Case Studies ◽

10.1177/1534650119890925 ◽

2019 ◽

Vol 19 (2) ◽

pp. 133-144 ◽

Cited By ~ 1

Author(s):

Joseph N. Ricciardi ◽

Sonya Woelfel Bouchard ◽

James K. Luiselli ◽

Trudy Dould

Keyword(s):

Brain Injury ◽

Behavioral Intervention ◽

Performance Feedback ◽

Treatment Plan ◽

Challenging Behaviors ◽

Low Frequency ◽

Acquired Brain Injury ◽

Care Providers ◽

Community Based ◽

Baseline Phase

We present the case of a 30-year-old woman who had acquired brain injury (ABI) and demonstrated clinically challenging behaviors (verbally abusive outbursts toward care providers and elopement) within her community-based group home. Following a baseline phase of evaluation, she collaborated with clinicians and care providers in developing a treatment plan that included personal goal setting, differential token reinforcement, communication training, graphic performance feedback, and reinforcement fading. During 10 months of intervention, clinically challenging behaviors steadily decreased from baseline levels and low-frequency occurrence was maintained at 3-, 6-, and 9-month follow-up assessments. As the result of treatment, the woman also avoided prior psychiatric hospitalizations, enjoyed more frequent access to pleasurable activities outside her residence, and enrolled in a college course. The study illustrates an effective person-centered therapy approach combined with behavioral intervention for persons who have ABI and experience community-living adjustment difficulties.

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Everyday Choice Making: Outcomes of Young People with Acquired Brain Injury After Moving from Residential Aged Care to Community-Based Supported Accommodation

Brain Impairment ◽

10.1017/brimp.2015.32 ◽

2015 ◽

Vol 16 (3) ◽

pp. 221-235 ◽

Cited By ~ 8

Author(s):

Dianne Winkler ◽

Libby Callaway ◽

Sue Sloan ◽

Nadine Holgate

Keyword(s):

Brain Injury ◽

Young People ◽

Acquired Brain Injury ◽

Aged Care ◽

Residential Aged Care ◽

Small Scale ◽

Structured Interviews ◽

Community Based ◽

Choice Making ◽

Supported Accommodation

Objectives: (1) Examine the opportunities young people with acquired brain injury (ABI) have to make everyday choices after moving out of residential aged care (RAC) into community-based shared supported accommodation (SSA); (2) Compare everyday choice making of this group with a group of people with ABI living in RAC.Research design: Mixed methods comparing two independent groups.Method and procedures: Responses on eleven relevant items of the Resident Choice Scale (RCS) were compared between two groups; 45 people with ABI living in RAC and 20 people with ABI who had moved from RAC to live in SSA. In addition, the choice making experiences of the SSA group were investigated through semi-structured interviews with the individual and/or their family member. Interviews were recorded, transcribed and thematically analysed.Results: Greater opportunities for everyday choice making were demonstrated on 10 out of the 11 RCS items for people living in SSA, compared to RAC. These included improved choice regarding meals, bedtime and leisure activities. Qualitative data also illustrated new choice opportunities afforded to the SSA group. Five key themes relating to choice were identified: rules and routines, communication, things to do, food and home-like environment.Conclusions: Community-based, age-appropriate and small-scale supported accommodation provides people with ABI more opportunities for everyday choice making than RAC.

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