A Unique Approach To Working with Families Post-TBI
Dr. Kreutzer and Dr. Stejskal talk about their work with people with traumatic brain injury and their families.
You asked about the uniqueness of our approach. Many people who intervene with families do use mostly common sense, and that's a great approach. We've seen lots of families--thousands. We've talked to a lot of families to try to understand what their issues are, and we've reviewed a lot of the research on families, and we've taken all that information and put it together, and we've realized there are certain important elements. Our approach emphasizes teaching family members and people with brain injuries skills, providing psychological support and education. It's a combination of those three things that I believe makes our approach unique. The second is that many people who see families will focus on one issue, cognition, or they'll focus on problem solving. What we do with families is to cover a breadth of issues ranging from communication to managing stress to learning how to take care of yourself. We've established what we call a curriculum, a set of topics that we cover with most of our families. A third part of what we've done, and we've probably spent a good 8 or 9 years doing this, is we've written a lot in language that consumers and family members and survivors could understand. We've written a lot of newsletter pieces. We've written a number of books just for families and survivors. And a hallmark of our approach is when we see families after the session with families and the survivors, we give them information materials they can take away with them to review in between sessions. Another important hallmark of our approach is asking people questions. And what a lot of therapists may do is to spend a lot of time giving people advice. What we try to do is rather than tell people what they're feeling or thinking or doing that doesn't work or that does work is we ask people lots of questions, and we use the answers to those questions to facilitate introspection, to facilitate what we call self-monitoring, helping people to understand what they're thinking and feeling, and that allows people to be more independent in the long term. And in addition to that, I think the Brain Injury Family Intervention Program is unique in the sense that it's theory driven. We draw on cognitive behavioral theory as well as family systems theory, and what that indicates to us is that we're not just working with the person that had the injury or the person who is doing the majority of the care giving, we're trying to get as many family members into that room as possible and sending the message that this is not just an issue for the person who was injured or the person who now identifies as caregiver, but something very important and palpable has changed for every family member, and that might be something different and on different levels, but we're talking about a family and a couple issue here, not just an individual issue. The third piece that comes to mind is the fact that we have evidence behind our program. We've been able to do statistical analyses and publish a number of articles. When we look in the literature at other programs that have done family intervention, a lot of times they will exclude the person that had the injury or not collect any data on that person. And so what we've found is that our program actually benefits both the family member and the person that had the injury.
Posted on BrainLine May 27, 2009.
Produced by Victoria Tilney McDonough and Brian King.
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.