Changes in the Brain by Nancy D. Chiaravalloti & Yael Goverover

Author:Nancy D. Chiaravalloti & Yael Goverover
Language: eng
Format: epub
Publisher: Springer New York, New York, NY

Jody’s case highlights the persisting and hidden symptoms that can occur after mild TBI, as well as the challenges that a person who returns to work may face. Co-workers may easily misinterpret errors or cognitive symptoms as laziness, lack of effort, or not caring. This can create resentment and tensions with co-workers. Accommodations such as a reduced work day and schedule, additional time to complete tasks, or additional structure (written directions) may be needed. If a person returns to work too soon and experiences failure, such as in the case with Jody, secondary problems such as anxiety and depression can occur and further compound the recovery process. A person with a mild TBI may find that as they re-enter the work force, they need to accept a position with lower salary and responsibility because they are no longer able to handle previous responsibilities.

Persons with moderate to severe problems may need intensive support and a specialized vocational program to return to work. Specialized programs typically include simulation and practice of work skills as well as guided practice in actual work situations. Such programs typically have access to special job placements and some programs use a supported employment model that includes use of job coaches. Job coaching includes one to one training within the work environment. In general, successful return to work after a TBI has been shown to improve with specialized vocational interventions (Fadyl & McPherson, 2009).

Return to school: The problems in returning to school to resume previous studies or to pursue future goals parallels that of returning to employment. Students may need additional resources, support, and accommodations to be successful including extended time for assignments and exams, use of a reader, reduction of course load, a note taker, tape recording of lectures, and structured directions for assignments. Even with accommodations, many students need to modify their course of study or revise vocational goals.

Leisure : Following a TBI, it is important for a person to find meaningful activities that bring enjoyment and satisfaction. When we immerse ourselves in hobbies such as gardening, photography, pottery or something else that we love doing, it stimulates our minds, structures our time, connects us with others, and helps us feel good about ourselves. Part of the process of rebuilding a sense of self is helping a person connect to those activities that bring pleasure, as well as a sense of accomplishment and fulfillment. Sometimes, this involves re-connecting with previous interests and activities and other times, it may involve discovering new activities to replace or substitute for activities in which the person is no longer able to engage. If a person is unable to return to work, leisure activities and interests become a main source of life satisfaction. Engagement in such activities is important to one’s sense of accomplishment, self-esteem, self-confidence, and overall health (Bier, Dutil, & Couture, 2009).

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