Socializing Safely After TBI

Ask the Expert: Socializing Safely After TBI

My 24-year-old daughter who sustained a TBI more than a year ago wants to rejoin her social circle. I am worried that this means she will use alcohol and possibly other substances. How should I handle this?


This is a difficult question to answer without more information. Your first thought, of course, is to protect your daughter. But on a general level, what we do know is that alcohol often has an exaggerated effect on an injured brain; one beer may have the effect of three beers and can further compromise cognitive issues such as judgment, impulsivity, problem-solving, decision-making, and disinhibition. Illegal substances are not only harmful but they can increase the risk of a second brain injury as well as problems with the law. Alcohol and recreational drugs are dangerous when used in conjunction with prescription medications commonly used after brain injury for the treatment of seizures or psychological disorders.

The steps you take next depend on many factors including your daughter's level of functioning, the services she is currently receiving, your mother/daughter relationship, and the willingness and ability of her friends to provide support.

For people with significant challenges, there is a wonderful model you may want to look at called the Circle of Friends. This is a step-by-step process for building a social support network.

If your daughter has a treatment team, counselor, or coach, talk with them about how to handle this complex issue. If you do not have professional support, you might want to consult a mental health professional with expertise in this area. Ideally, your daughter would be aware of her own limits and would talk with her friends to enlist their help in keeping her safe.

If possible, work with your daughter and her friends to develop a plan for gradually reentering her social circle — starting with brief daytime outings and progressing to longer activities with less supervision. For all of these suggestions, open, nonjudgmental communication is crucial.


Posted on BrainLine April 29, 2009.

Comments (5)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

As someone who has had a TBI for over 27 years, I can tell you this: If she drinks and does the other stuff, you can't stop her (not to be mean or anything, sorry if that did sound cold). If she didn't have the injury, would she do those same behaviors? Being only 1 year out after her injury, depending on the severity, she might revert back to her old behaviors, but that's a 50 / 50. I've found that many people who suffer from a TBI make the wrong decisions like they were back living like they were teenagers, but that's also dependent on where the most significant damage was done on her brain. There are many factors that shape a person who has had a TBI.

Did he have a few friends before he entered the place he is in now? A circle of friends can include relatives, old friends, make new friends and include a coordinator. People of different ages and interests can join in. Funding can pay for bowling

I am a physical therapist and I was one of the physical therapists working with Tim Rocchio at North Broward Medical Center in 1982. I recall Anita the speech therapist as well. Paul was the rehab director at that time. I would love to contact either Anita or Carolyn is there anyway I can do that. Taryne PT

I have really appreciate BrainLine's work. I would like to interject on the individual knowing their limits. The brain naturally enjoys the alteration and will want more to a point where it is unhealthy typically speaking. Teach them responsible use. Think of it in doses.  

We are dealing with this now. But our son has no friends to take him out. He lives in a nursing home. Any comments?