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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.

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.

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.

Children with acquired brain injury (ABI) are at significant risk of serious behavioural and social difficulties. The burgeoning growth of research documenting behavioural sequelae after paediatric ABI has not been met with a concomitant level of research aimed at treating the problem. The purpose of this paper is to investigate whether a manualised behavioural intervention support programme could reduce challenging behaviours in children with ABI and improve family-parental well-being and functioning.

A total of 61 parents (48 mothers and 13 fathers) of 48 children aged between three and 12 years with mild, moderate, or severe ABI received an ABI adapted “Signposts for Building Better Behaviour” programme (Hudson et al., 2001) in group-support (GS) or telephone-support (TS) format. Trained “Signposts” practitioners delivered the programme over a five-month period. The programme consisted of nine information booklets, a DVD, and workbook. All families completed pre-intervention and post-intervention evaluations.

On an average parents completed 7.92 out of a possible nine intervention sessions (range 7-9). Parents in both TS and GS formats reported significant reductions in challenging child behaviours irrespective of injury severity. They also reported significant reductions in dysfunctional parenting practices, stress and family burden.

Overall, the current research provides support for Signposts to be used with families of children with ABI in an attempt to ameliorate negative outcomes for family, parent, and child.

Where no psychosocial or interventional support is provided, children with acquired brain injury (ABI) are at significant risk of serious long-term behavioural and social difficulties. The purpose of this paper is to report the six- and 18-month long-term treatment effects of a family centred behavioural intervention to help families manage and prevent challenging behaviours in children following ABI.

In total, 31 parents were followed up at three time points (post-intervention, 6 and 18 months) after participating in an ABI adapted manualised “Signposts for Building Better Behaviour” programme (Hudson et al., 2003).

Attrition rates were highest amongst families caring for a child with mild ABI. The maintenance of treatment effects were detailed for those families who reported a reduction in challenging behaviour immediately post-intervention. There were no significant elevations in challenging child behaviour, maladaptive parenting, or family dysfunction for any participants over the long-term follow-up. Irrespective of injury severity, parents reported high levels of satisfaction and efficacy in the parenting role at 18 months post-intervention.

“Signposts” has further demonstrated its clinical viability by meeting the needs of parents who have a child with ABI in both the short- and longer-term.

Brain Injury Case Managers (BICMs) work closely with individuals with Acquired Brain Injury (ABI), assessing needs, structuring rehabilitation interventions and providing support, and have significant experience of clients with impairments to decision making. The purpose of this paper is to explore the application of the Mental Capacity Act (MCA) and its guidance when applied to ABI survivors. This research aimed to: first, highlight potential conflicts or tensions that application of the MCA might pose, and second, identify approaches to mitigate the problems of the MCA and capacity assessments with ABI survivors. It is hoped that this will support improvements in the services offered.

Using a mixed method approach, 93 BICMs responded to an online questionnaire about decision making following ABI. Of these, 12 BICMs agreed to take part in a follow-up semi-structured telephone interview.

The data revealed four main themes: disagreements with other professionals, hidden disabilities, vulnerability in the community and implementation of the MCA and capacity assessments.

The findings highlight the need for changes to the way mental capacity assessments are conducted and the need for training for professionals in the hidden effects of ABI.

Limited research exists on potential limitations of the application of the MCA for individuals with an ABI. This paper provides much needed research on the difficulties surrounding mental capacity and ABI.

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.

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.

Rather than emphasising the earlier disadvantages that Corrections Victoria (CV) Australia, the world's first acquired brain injury (ABI) program, has experienced, this paper aims to highlight how this clinical position has improved best practice outcomes and solutions for offenders in the Victorian forensic system.

Over the past three years, CV Australia has made a commitment towards better meeting the needs of offenders with a disability. Specific research has been undertaken to identify the prevalence of acquired brain injury among Victoria's male and female population. This world‐first research for CV by its research partners, arbias Ltd and La Trobe University, has identified new challenges particularly evidence concerning the large‐prisoner cohort with acquired brain injury.

The acquired brain injury clinician within CV is a new position, an innovative service for prisoners and offenders with an ABI in the North West Metropolitan Region, Melbourne. What has emerged in the first 18 months of the ABI program is the presence of co‐morbidities, including mental health and substance use issues in addition to the prisoner/offender's cognitive impairment. This complex profile confirms the need for a specialist response. The role of the clinician is multi‐functional, including consultation, capacity building, information, education, intervention planning and staff training.

The practical implications of this case study include a treatment plan; however, there are issues with implementing this approach as it requires a long‐term commitment from the correctional services system.

In recent months, a number of strategies have been implemented to better support the prisoners who have cognitive impairment. Success of these strategies can make lasting changes to not only the offenders, but also CV staff. The CV staff noted that while resources (time spent) have been heavily invested in the individual learning, this has been an effective strategy. This case study highlights how CV is responding to the research into prisoners/offenders with an acquired brain injury.