Traumatic brain injury (TBI) is a pervasive public health problem in the United States, as well as worldwide. Given that the estimated incidence of TBI is 1.4 million new injuries per year in the United States,1 with approximately 5.3 million individuals living with significant disability as a result of TBI,2 it is very likely that social workers in the healthcare arena will encounter at least one client who has sustained a traumatic brain injury in their work experience. Despite the high incidence of TBI, information to help guide the social worker who may not have had education or training regarding issues relevant to working with clients with TBI has not been readily available.
Specialized services are often available for those who experience TBI through trauma centers and neurosurgical intensive care units in major medical hospitals, rehabilitation hospitals with specialized units for brain injury rehabilitation, outpatient comprehensive brain injury rehabilitation programs focused on community re-entry, transitional living centers for persons with brain injury, and community-based brain injury programs. Social workers employed in these various settings will likely become “experts” in working with those with TBI. Training for such individual social workers may happen “on the job,” and through inservices, seminars, and individual study.
While a subset of individuals affected by TBI will receive specialized brain injury care in one of the settings mentioned above, a great number of individuals will receive their care after injury in general medical settings, in a general rehabilitation unit with no special expertise in working with issues related to TBI, in primary care settings, and in social service settings. In these situations, social work professionals encountering individuals with TBI will be less likely to have access to training or educational materials that may assist them in the care of those with TBI. This manual has been developed to help fill this gap, by serving as a resource to social workers who encounter clients with traumatic brain injury in their clinical practice. The goal of this educational tool is to assist social workers to feel more comfortable and confident in their clinical interactions with clients with brain injury, to increase knowledge regarding TBI, to outline skills that are useful in working with clients with TBI, and to highlight resources that may be of use to clients with TBI and their family members. Ultimately, the aim of this training tool is to improve the overall quality of care that individuals with TBI will receive in various healthcare settings.
In the initial sections of this manual, general information about TBI and clarification of some terminology is presented. The remainder of the manual has been organized in accordance with a problem-focused model of practice, as outlined by Compton and Galaway (1989)3 in their classic text “Social Work Processes.” It is hoped that this structure will enhance the applicability of this material to your clinical practice.
From TIRR Memorial Hermann and Baylor College of Medicine. Used with permission.