For those who suffer a brain injury, the path to recovery can be long and demanding. However, with modern techniques and technologies, brain injury therapy is more developed than ever before. With some references from the Brain Injury Resource Center (BIRC), as well as exclusive information from a Professional Clinical Counselor based out of Ohio, we will summarize current brain injury therapy.
The main focus of brain injury therapy is restoration of brain function. The secondary focus is on the emotional and psychological aspects of sustaining a brain injury. The restoration of brain function involves two essential processes. One is restoring those functions that can be fully restored, and the other is teaching a patient how to adjust to whatever cannot be restored. The emotional and psychological aspects of brain injury therapy focus on reintegration into society, as well as maintaining a healthy outlook.
Because of the broad range of impact a brain injury can have on neurological function, a battery of tests must first be performed on a patient before any therapy can begin. That being said, let’s discuss the problems that result from brain injury, as well as the basics on treating such problems during brain injury therapy.
Results of a Brain Injury
Again, the problems that arise for brain injury victims are different from case to case. Put twelve people through the same head injury, and you’re likely to see a dozen differing results. However, the BIRC believes some basic questions must be answered in every brain injury case: What can s/he do? How much does s/he know? Can s/he communicate? These and other basic questions will likely be answered in the pre-therapy tests, but the answers determine how intensive the therapy will be.
As long as a patient’s executive functions are intact, s/he should be able to maintain an independent lifestyle. The damage of cognitive functions, while sometimes crippling, rarely leads to the need for around-the-clock care. What this all means is that as long as you can perform human tasks, such as eating, sleeping, bathing, etc. (executive), then you can live without fully functional thinking/sensing abilities (cognitive).
If and when a patient’s executive functions are damaged, s/he may no longer be capable of living an independent life. Even with fully functioning cognitive abilities, the inability to perform human tasks creates the need for constant care.
Brain Damage Effects
When injured, the brain often becomes bruised, resulting in swelling. Very often with brain injury, that swelling of the brain causes short-term problems that fix themselves once the brain reverts to normal size. This is important to remember when diagnosing brain damage. It can take a few weeks for the brain to fully contract. This is a form of diffuse brain damage, meaning it is widespread throughout the brain.
Focal brain damage can be permanent, though. This is when a specific region of the brain is injured. “Improvements can occur as other areas of the brain learn to take over the function of the damaged areas,” says the BIRC, but this is not foolproof. If either diffuse or focal brain damage is severe enough, a patient may enter an unconscious state, called a coma.
For conscious brain injury victims, the effects of the damage often include difficulty concentrating, organizing thoughts, and remaining coherent. Confusion, forgetfulness, and trouble in social situations are also common. Some patients will find it hard to learn new information, and others may lose some learned information. Problem-solving, decision-making, planning, and making good judgments are all usually affected.
Another major area of difficulty for brain injury victims is language. Trouble using the right words is common, as well as strange descriptions. The BIRC says for instance that someone asking for a belt may ask for “the circular cow thing that I used yesterday and before.” Slow, slurred, and even incomprehensible speech is also common among victims. This only occurs when regions of the brain responsible for speech mechanism and/or muscle control become damaged.
The initial battery of tests performed on brain injury victims will include evaluations of attention, memory, speech, overall bodily function, and something known as ADL, or activities of daily living. These include all the basic parts of a day, such as dressing, bathing, cooking, etc. The rehabilitation of ADL can take up to a full year. All the while, the patient is being assessed.
Neurologists, pathologists, neuropsychologists, and other brain injury specialists will team-up and create a full assessment of a patient. This includes a diagnosis, as well as a plan for treatment. The next step in brain injury therapy is treatment, and this usually begins during the assessment process, right in the hospital room.
As mentioned, the team of doctors will work on their patient’s alertness, attention, overall orientation, and communication skills while s/he is still in the hospital. It is very important to rehab these areas immediately, before any long-term damage can set in. Once the patient is discharged, long-term treatment begins.
Most often, long-term brain injury treatment occurs in a facility specifically designed for such patients. At these facilities, the same areas as discussed above are treated, just with more intensiveness. Patients will integrate back into normal life through these facilities. As stated by the BIRC, “The goal of rehabilitation is to help the individual progress to the most independent level of functioning possible.” Reacquiring lost skills, plus learning ways to make up for skills that can’t be reacquired, is the ultimate goal of brain injury therapy.
Brain injury victims are usually unaware of their condition. Therefore, the errors they make as a result of their injuries are rather frustrating to them. For example, imagine your fingers were disabled, but you didn’t know anything was wrong with your hand. No matter how hard you try to make a fist, you just can’t. Now apply that frustration to, say, forming a sentence. One can only imagine…
Worse yet, victims often blame others for their errors. Anger management is highly recommended for those who experience this frustration. The BIRC states that anger management therapy helps build coping mechanisms, avoiding outbursts that can be destructive at times. Psychological counseling is also recommended, as even rehabilitated brain injury victims sometimes experience trouble in daily life. Problems at home, at work, or in their social lives are all too common among brain injury victims.
We were lucky enough to talk with a brain injury specialist with over fifteen years of experience. She works out of Ohio, and will not be named in this article for professional reasons. She specializes in multiple areas: drug/alcohol addiction treatment, ADL education, counseling, mental health treatment, and family education.
Her self-designed brain injury treatment program incorporates aspects from drug/alcohol treatment, brain injury treatment, and art therapy. This unique combination allows her patients to develop in a well-rounded manner. She was generous enough to share with us a list of “what individuals are tested on to become a certified brain injury specialist.” We conclude with this list, as it offers distinct areas for further research. The percentages on the right indicate the weight of each topic upon testing.