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The purpose of this paper is to examine the research into prevalence of acquired brain injury in non-ABI specialist services, the impact of the invisible aspects of executive impairment and loss of insight upon functioning and to question how this is assessed and managed by generalist services.

A literature search was undertaken to identify where people with an ABI may come in to contact with services that are not specifically designed to meet their needs.

ABI is prevalent amongst users of a variety of community, inpatient and criminal justice services. The common albeit invisible consequences of ABI complicate assessment, service use and or treatment particularly in the context of a lack of under pinning knowledge and experience amongst the staff in non-specialist ABI services. As a consequence risks to children and adults are increased, opportunities for rehabilitation and growth are lost and human potential squandered. Addressing the first stage in this process, developing knowledge of the consequences of ABI and how to assess need, is a pre-requisite for change.

An absence of basic underlying knowledge of the consequences of ABI impacts upon assessment and so limits the effectiveness of services. A consequence of this is manifest in the over-representation of people with an ABI to be found in non-specialist settings.

–Little research is undertaken from a social and community perspective into the impact of ABI over the longer term for those who have no contact with specialist services and yet, quite clearly by their use of other services, have unidentified, unrecognised and un-responded to needs.

The purpose of this paper is to outline a work‐based, professional education series of workshops, focusing on issues of sex and sexuality training for health and social care professionals who work with adults with a moderate to severe acquired brain injury. The series of workshops were conducted by a trained psychosexual therapist and couples counsellor from Headway Brain Injury Association, and held at the Royal Hospital for Neuro‐disability in 2009 to raise health and social care professionals' awareness about sexuality issues for this patient population. A case study of the series is presented, which we hope will add to the discourse about the sexual needs of people with a moderate to severe acquired brain injury. Overall, participants were positive about the education and learning achieved within the workshop series.

Acquired brain injury (ABI) can happen to anyone at any time. As a result, the person can experience a wide range of difficulties related to a combination of physical, cognitive, behavioural and emotional changes. It is the less obvious social and emotional difficulties in particular that present challenges to community integration and require major life adjustment.The type and level of support needed by people living with a brain injury is as unique as the person and their experience. The role of the support worker is open‐ended and tailored for each client; therefore, support workers are expected to have a wide and dynamic range of skills and qualities. Support workers need not only to understand the effects of ABI and its impact on the lives of individuals and their families, but also the influence of different values and attitudes on the support worker/client relationship.This article discusses some of the particular needs of a person after an ABI, what makes the role of the support worker different when working with this client group and what, as practitioners, we need to consider in terms of support worker training. Consideration is given to the influence of new Care Quality Commission (CQC) regulations and the introduction of a personalised system of care, two recent and significant changes related to the provision of adult social care services. Finally, the article goes on to look at an accredited programme ‘Supporting an Individual with Acquired Brain Injury’ as an example of one approach to providing specialist training.

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.

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

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.

Reminiscence involves individuals discussing memories and experiences from their remembered past. With the aid of memory‐jogging materials such as photographs, music and newspapers, reminiscence has been widely used with older adults who have significant memory impairments as a consequence of dementia. This paper seeks to describe the use of reminiscence within a brain injury rehabilitation unit, including how to facilitate sessions and explore outcomes when using it with individuals who have brain injuries. Dementia Care Mapping was used to measure mood and engagement of participants in a reminiscence group, and self‐ratings that allow participants to comment about sessions were also obtained. Results indicate improvements in mood and engagement, as well as positive ratings from participants. Recommendations regarding the use of reminiscence are extended to include using it with adults with acquired brain injury within residential, day or community settings.

This paper aims to consider the new role of Client Support Co‐ordinator (CSC), which is being developed by some law firms, and the assistance this can provide for brain injury survivors and their families and carers.

This article considers how the CSC can assist in the early acute stages following acquired brain injury. It is designed to take the reader through the benefits that a CSC can bring in supporting not only the brain injury survivor but also their families and carers. The literature is reviewed briefly, followed by reflections and suggestions which are based on this review and on practical experience.

This role is designed not to replace but to supplement existing social care providers and to bridge the gap in a legal case between receiving first instructions and the instruction of a private case manager. By adopting a more proactive, holistic case management type service at the acute stage the rehabilitation outcomes can be improved and families and carers better supported. Specialist brain and serious injury lawyers involved in dealing with brain injury litigation will often face a number of practical problems prior to being able to prove legal liability. Once primary liability is confirmed lawyers can proceed to obtain interim payments to pay for a private case manager who will then arrange the client's care and rehabilitation package.

This article shows that during the initial process, this guidance and support for brain injury survivors and their families and carers is vital and any additional support that can be provided should be sought at an early stage. This paper demonstrates the efficacy of employing a client support co‐ordinator in this period.

This paper aims to highlight the challenges that case managers face in accessing appropriate statutory services and funding for young brain injured adults.

The paper uses aggregate case material, based on two years of case management with young adults with an acquired brain injury.

There is a need for separate, dedicated acquired brain injury services within local authority adult services. There should be a greater emphasis on assessments of functioning and decision‐specific mental capacity for clients with acquired brain injury rather than simplistic assumptions of capacity. Health and social welfare professionals in this field need a knowledge of the law related to benefits disregard and mental capacity, including recent case law. The statutory complaints system can provide redress where statutory services have been wrongly withheld.

Case managers need to keep up to date with the case law and application of health, social welfare and mental capacity legislation in order to ensure clients' rights and access to statutory services and funding.

This paper provides a subjective account, and analysis, of the reality of independent case managers working proactively, pragmatically and intensively across multidisciplinary and multiagency settings in the pursuit of clients' statutory rights.

Positive sexual growth is a key developmental challenge for all children and adolescents. An acquired brain injury (ABI) can create major hurdles to achieving this goal. A conceptual model will be outlined that suggests sexual growth is achieved by progress across six domains, namely: social competence versus social isolation; identity formation, individuation and independence versus dependence and lack of individual identity; physical development versus physical challenge; sexually informed and educated versus sexually ignorant and uneducated; sexually experienced versus sexually inexperienced; and sexually appropriate behaviour versus sexually inappropriate behaviour. The ability to form successful peer relationships is a key mediating factor in the developmental process. Drawing on this model, a number of strategies will be outlined that support the positive sexual development of children and adolescents after ABI.

Clinically significant childhood acquired brain injury (ABI) is associated with increased risk of emotional and behavioural dysfunction and peer relationship problems. The purpose of this paper is to determine how emotional and peer related problems for children with ABI compare with those of children referred to mental health services, and to identify clinical predictors of peer relationship problems in a heterogeneous sample typical of a specialist community rehabilitation setting.

Participants were 51 children with clinically significant ABI (32 traumatic brain injury; 29 male) referred for outpatient neuropsychological rehabilitation. Emotional, behavioural and social outcomes were measured using the Strengths and Difficulties Questionnaire (SDQ), and executive functioning was measured with the Behaviour Rating Inventory of Executive Functions. Correlational analyses were used to explore variables associated with peer relationships. A subgroup (n=27) of children with ABI were compared to an age and sex matched mental health group to determine differences on SDQ subscales.

The SDQ profiles of children with clinically significant ABI did not significantly differ from matched children referred to mental health services. Time since injury, peer relationship problems, metacognitive, and behavioural problems correlated with age at injury. These variables and SDQ emotional problems correlated with peer relationship problems. Linear multiple regression analysis indicated that only metacognitive skills remained a significant predictor of peer relationship problems, and metacognitive skills were found to significantly mediate between age at injury and peer relationship problems.

The study confirms the significant effect of childhood ABI on relationships with peers and mental health, those injured at a younger age faring worst. Within the methodological constraints of this study, the results tentatively suggest that age of injury influences later peer relationships via the mediating role of poor metacognitive skills within a heterogeneous clinical sample.

This is the first study to examine the roles of emotional, behavioural and executive variables on the effect of age at injury on peer relationship problems in a sample with a wide range of ages and ages of injury.

Brain injury rehabilitation is often complicated or confounded by difficulties with engaging the injured party with the services and input required. Lack of awareness of cognitive and executive impairments is often implicated in this difficulty. Any technique or approach that enhances engagement may then support rehabilitation. The aim of this paper is to examine the current evidence base for the use of motivational interviewing (MI) as a method for increasing engagement by supporting the development of insight.

The paper is a literature review, taking as its basis Medley and Powell's conceptual review of MI and then examining the published evidence available.

Although attractive to practitioners in the field because the purpose of MI and the goals underpinning acquired brain injury (ABI) rehabilitation are co‐terminus, the theoretical and research findings to date that address the effective application of MI to ABI are inconclusive. The literature presently available suggests there is no conclusive evidence that MI is a more effective approach than any other, and that which is available makes little reference to the specific difficulties of an ABI population that may confound MI's application in this area.

There is currently no high standard of evidence to support the use of MI with people with ABI.

There are still very few papers written, or research undertaken, into the effectiveness of MI with people with a brain injury. Most of the work undertaken thus far is concerned with supporting behavioural change in this population when problematic alcohol or drug use is co‐morbid. This paper identifies some of the practical difficulties with the approach whilst recognizing the inherent value in its aims.

The paper provides an opportunity for practitioners who wrestle with the difficulty of engagement on a daily basis to reflect upon how present practice could be altered to increase the likelihood of supporting engagement.