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Just a little bit of history repeating: the recurring and fatal consequences of lacking professional knowledge of acquired brain injury

Mark Holloway (Head First Assessment and Case Management Ltd., Cranbrook, UK)
Alyson Norman (School of Psychology, University of Plymouth, Plymouth, UK)

The Journal of Adult Protection

ISSN: 1466-8203

Article publication date: 2 March 2022

Issue publication date: 26 April 2022




The purpose of this paper is to review safeguarding adult reviews (SARs) pertaining to individuals with acquired brain injury (ABI) since 2014. This extended literature review also explores the lessons and recommendations from these reviews in relation to social work practice within the UK.


The literature review reported and discussed findings across reviews and then used a thematic analysis to synthesise the findings and recommendations from the SARs reviews.


This paper identified four main themes: a lack of awareness of the needs of those with ABI and their families and around the symptoms and nuances of brain injury, particularly executive impairment and mental capacity, among social workers; poor interdisciplinarity led to a lack of shared communication and decision-making with professionals with such knowledge; a poor understanding of aspects of the mental capacity legislation, particularly surrounding unwise decisions, led to inappropriate or absent mental capacity assessments; and a lack of professional curiosity led to a lack of action where intervention or assessment was required.

Research limitations/implications

This review identifies significant shortcomings in social work practice, education and training within the UK with regards to ABI.

Practical implications

This paper provides recommendations to current social work practice and highlights the need for significant improvements in pre-qualification and post-qualification training and supervision of social workers.


To the best of the authors’ knowledge, while there have been extensive reviews conducted on SARs, this is the only review that has focused solely on ABI.



Holloway, M. and Norman, A. (2022), "Just a little bit of history repeating: the recurring and fatal consequences of lacking professional knowledge of acquired brain injury", The Journal of Adult Protection, Vol. 24 No. 2, pp. 66-89.



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