Adolescents and TBI

Adolescence is a tough enough time. What happens when a brain injury is added to the mix?

When it comes to adolescents, it's hard because a lot of aspects of being an adolescent or a teen, look like symptoms of brain injury-- impulsivity, moodiness, feeling very sad one moment and angry another moment, wanting to be independent and then wanting to be close, experimentation, sexual expression. And a lot of things--a lot of symptoms of brain injury look like adolescence. One thing that a professional in your community can help you do is kind of help you sort that out. And I say to families a lot of the times--they say, "Do we have a problem?" And I say, "Well, if you're feeling concerned, if you're having a difficult time, if you feel uneasy, then at the very least, we're having a problem where you're feeling those particular ways. Some families feel like they're doing okay and they don't have anything that they're very concerned about, and other families feel like they have so many complex issues. And families that I work with will even say to me, "Gosh, how do you even work with us? We must be so difficult to deal with." And I say, "The person who thinks that you're the most difficult to deal with is you. So you're really not that hard." But I think consulting with a professional and saying, "Here's some of the things that we're experiencing. We're wondering if we should be concerned or not," is a great idea because either you're going to have someone who can work with you through those problems, or you're going to have someone give you some peace of mind and say, "What you are experiencing is very normal, and here are some things you can do to weather the storm in the meantime." And one thing to keep in mind is that things have changed a lot in the brain injury world over the last 20 or 30 years. Most states now have a very good brain injury association, and most of the brain injury associations in every state are aware of what the local resources are. So I would recommend--and we routinely recommend to families that we see-- to contact the Brain Injury Association to get information on support groups, conferences. And the other source of good information about rehabilitation and family support is your local rehabilitation hospital. Most of them are very effective at doing what they do, and they know what kinds of services are available, where to find them in rural communities, as well. So I think somewhere between rehabilitation provider organizations and advocacy organizations, like the Brain Association, families can get good leads on where to find help in their local community. Taryn and I work closely together and that gives us options because we have, in some cases, worked with a family both Taryn and I seeing the family and, in some cases, one of us will see the parents and the other one will see the adolescent. Adolescence is a time when people are seeking independence, and one of the things that tends to happen when an adolescent is injured is there's a real concern about protecting that child, and so the adolescent often gets very frustrated that there's a lot of things that they can't do anymore. So individual therapy, providing the adolescent with an opportunity to express their feelings, their fears, their concerns, their sense that they're losing their freedom, is really important to give that person a voice. And what we'll often do is combine the individual sessions with the adolescent with additional sessions that involve the family because one of the things that we found out for sure-- there's no question the parents are very, very concerned and they need to be-- they need information, they need to understand a little bit about what's happening. So we'll use a dual-focus kind of approach when there's an adolescent that needs some individual time.
Posted on BrainLine March 16, 2010.

Produced by Victoria Tilney McDonough and Brian King.

About the author: Jeffrey Kreutzer, PhD

Jeffrey Kreutzer, PhD a Professor of Physical Medicine and Rehabilitation, Neurosurgery, and Psychiatry at VCU. He serves as Director of Virginia's TBI Model System, a position he has held since 1987. He also coordinates VCU Health System outpatient services for families and persons with brain injury.

Dr. Jeffrey Kreutzer