Guidebook for Psychologists: Working with Clients with Traumatic Brain Injury

This guide for professionals was created by Margaret A. Struchen, Ph.D., Assistant Professor, Dept. of Physical Medicine & Rehabilitation Baylor College of Medicine, Research Scientist, Brain Injury Research Center, TIRR Memorial Hermann; Lynne C. Davis, Ph.D., Research Scientist, Brain Injury Research Center TIRR Memorial Hermann; Stephen R. McCauley, Ph.D. Assistant Professor, Dept. of Physical Medicine & Rehabilitation Baylor College of Medicine; and Allison N. Clark, Ph.D., Assistant Professor, Dept. of Physical Medicine & Rehabilitation Baylor College of Medicine. Download the full PDF to find the following content:

• General Information: Brain Injury 101—Traumatic Brain Injury FAQs
• Reasons for Referral to Clinical or Counseling Psychologists
• Behavioral Issues
• Relationship Issues
• Assessment Issues
• Issues related to interventions
• Appendix I Clarification of Issues Regarding Injury Severity
• Appendix II Neuroanatomical Correlates of Common Referral Issues
• Appendix III Sample Resource List

Here is an excerpt of this guide:

Introduction

Traumatic brain injury (TBI) is a pervasive public health problem in the United States, as well as worldwide. Given that the estimated incidence of TBI is 1.4 million new injuries per year in the United States,1 with approximately 5.3 million individuals living with significant disability as a result of TBI,2 it is very likely that psychologists in the healthcare arena will encounter at least one client who has sustained a TBI in their work experience. Despite the high incidence of TBI, information to help guide psychologists who may not have had specialized education or training regarding issues relevant to working with clients with TBI has not been readily available.

Specialized services are often available for those who experience TBI through trauma centers and neurosurgical intensive care units in major medical hospitals, rehabilitation hospitals with specialized units for brain injury rehabilitation, outpatient comprehensive brain injury rehabilitation programs focused on community re-entry, transitional living centers for persons with brain injury, and community-based brain injury programs. Psychologists who are employed in or serve as consultants to these various settings will likely become “experts” in working with those with TBI. Training for such psychologists may happen “on the job,” and through inservices, seminars, and individual study.

While a subset of individuals affected by TBI will receive specialized brain injury care in one of the aforementioned settings, a great number of such individuals will receive their post-injury care in general medical settings, in a general rehabilitation unit with no special expertise in working with issues related to TBI, in primary care settings, and in social service settings. In these situations, psychologists encountering individuals with TBI will be less likely to have access to training or educational materials that may assist them in the care of those with TBI. This manual has been developed to help fill this gap, by serving as a resource to psychologists who encounter clients with traumatic brain injury in their clinical practice. The goal of this educational tool is to assist clinical and counseling psychologists to feel more comfortable and confident in their clinical interactions with clients with brain injury, to increase knowledge regarding TBI, to outline skills that are useful in working with clients with TBI, and to highlight resources that may be of use to clients with TBI and their family members. Ultimately, the aim of  this training tool is to improve the overall quality of care that individuals with TBI will receive in various healthcare settings.

In the initial sections of this manual, general information about TBI and clarification of some terminology are presented. The remainder of the manual will outline the likely reasons that clients with TBI might be referred to a psychologist for care, will address issues relevant to assessment for those with TBI, and will review issues relevant to the provision of interventions for such individuals.

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