Suggestions for Working with Persons Who Have TBI
Carefully observe and assess the person's unique communication and learning styles.
- Ask how well the person reads and writes; or evaluate via samples.
- Evaluate whether the individual is able to comprehend both written and spoken language.
- If someone is not able to speak (or speak easily), inquire as to alternate methods of expression (e.g., writing or gestures).
- Both ask about and observe a person’s attention span; be attuned to whether attention seems to change in busy versus quiet environments.
- Both ask about and observe a person’s capacity for new learning; inquire as to strengths and weaknesses or seek consultation to determine optimum approaches.
Help the individual compensate for a changed learning style.
- Modify written material to make it concise and to the point.
- Paraphrase concepts, use concrete examples, incorporate visual aids, or otherwise present an idea in more than one way.
- If it helps, allow the individual to take notes or at least write down key points for later review and recall.
- Encourage the use of a calendar or planner; if the treatment program includes a daily schedule, make sure a "pocket version" is kept for easy reference.
- Make sure homework assignments are written down.
- After group sessions, meet individually to review main points.
- Provide assistance with homework or worksheets; allow extra time for tasks that involve reading or writing.
- Ask family, friends, or other service providers to reinforce goals.
- Remember that something learned in one situation may not be generalized to another.
- Repeat, review, rehearse, repeat, review, rehearse.
Provide direct feedback regarding inappropriate behaviors.
- Let a person know a behavior is inappropriate. Do not assume the individual is making a conscious choice to act out or is even aware that he is misbehaving.
- Be clear about the behaviors that are expected and provide direct feedback when inappropriate behavior occurs.
- Redirect tangential or excessive speech, and establish a method to unobtrusively signal inappropriate behavior in public.
Remember that non-compliant behaviors may be symptoms of neurological deficits.
- Do not presume that non-compliance arises from lack of motivation or resistance, check it out.
- Be aware that unawareness of deficits can arise as a result of specific damage to the brain and may not always be due to denial.
- Confrontation shuts down thinking and elicits rigidity; roll with resistance.
- Absences or lack of follow-through may be reasons to change treatment strategies. Don't rush to discharge.
pdf of "Suggestions for Substance Use Treatment Professionals Working with Persons with TBI"