The term brain injury conjures fear any person who has even vague understanding of its meaning. Could greater fear exist among the elderly as they approach age related vulnerabilities due to degenerating physical ability, creating higher risk of falls and other circumstances potentially affecting neurological functions?
Highlighted here is information related to the benefits of psychological practice within rehabilitation facilities for geriatric brain injury clients, their interactions with these clients and other professional stakeholders, legislated educational and practical competencies, and application of proven therapies.
As with all therapeutic considerations, …show more content…
patients must be extended a personalised response from their health care providers to plan for a specific and individualised outcome. Patient’s individual needs will also be discussed here in terms of recognising the value of various sub-categories of psychology. During rehabilitation, it must be remembered, not only does the physical body require healing, but also the health of the psychological being. Therefore, consideration of developmental psychology, psychology of society and culture, abnormal and health psychology, and psychology of intelligence and personality, within the context of therapeutic delivery is necessary to ensure maximised rehabilitation outcomes.
Psychologist’s involvement has great value within the scope of the rehabilitation context, with functions ranging from testing, analysis, treatments and therapies for a wide range of emotional, behavioural and cognitive competencies, that can then be used to formulate plans and goal oriented outcomes for clients to restore to a standard of living, closest to which existed pre injury.
(Cifu, Kreutzer,Marwitz, Rosenthal, Englander, High, …show more content…
1996).
Rehabilitation of geriatric brain injury clients begins with establishing causation. For instance, was the injury trauma, stroke, dementia etc? To serve the client is to understand the natural state of living before the neurological changes created disruption to their life. (Woodard, 2010).
Previous study (Semlyen, Summers, Barnes, 1998) has shown greater improvements in rehabilitation where the client was the subject of a cohesive team approach from the various professional stakeholders. The psychologist must embrace (and expect) cooperation within a multidisciplinary professional team (comprising physiotherapists, speech pathologists, nurses, and social workers), through open dialogue and appropriate ethical information exchange. An interactive program, whereby a patient (within the realms of their physical, emotional and cognitive capabilities), should have involvement of various consultation types. For instance, a client would benefit from one on one sessions with their psychologist. The value for the client could be further enhanced by adopting an interactive team meeting approach whereby including the client and all other involved professionals. A third type of meeting conducted involving only treating professionals to discuss relevant case findings would add even more value to the client’s accessibility to a thorough service. According to the Psychology Board of Australia (2010), to practice psychology, a student must first complete a Bachelor of Psychology with Honours. There are various options as to pathways for registration, including, continuation of studies for a further 2 years, by either completing Master’s degree, or complete a fifth year of study, adding a further 12 months internship under senior supervision. A student may also complete a four year Honours degree, then complete two years of internship. These internships relate to practicing general psychology. For registration in more specific areas of study, such as clinical psychology and clinical neuropsychology, the Psychology Board of Australia states that endorsement is required. This requires further studies of a doctorate in one of these specialist areas.
This additional area of study would be highly beneficial to clients within a geriatric brain injury facility. This is highlighted by the numerous employment opportunities advertised online by various brain injury facilities, https://nswhealth.erecruit.com.au/ViewPosition.aspx?Id=126450.
Evidence based practices are utilized by the psychologist, through sessions involving identifying areas of deficit. Once analysis has been conducted, a plan based on the areas of deficiencies is devised. This may include sessions to create new strategies for coping with feelings around acquired physical impairments and unfamiliar emotional states, such as depression, anger, anxiety, fear. (MU School of Health Professions, Department of Health Professions http://braininjuryeducation.com/Treatment/Psycho/Neuro-Services).
To maximise the effectiveness of psychology work in this unit, it is also important to integrate principles of various sub categories’ of psychological practice. Understanding and applying the key concepts within sub categories’ such as, developmental psychology, social and cultural psychology, health and abnormal psychology and individual differences, underpin the functions of the psychologist. Consideration of intelligence and personality in terms of assisting rehabilitation is imperative. It is from this point, the psychologist can begin to formulate a style and manner of communication that is appropriate, practical and understood, for the purpose of delivering meaningful and beneficial therapy. Interestingly, Burton, Western and Kowalski (2012) suggested that during times of emotional instability, such that may evolve during the rehabilitation phase after brain injury, clients may adopt defence mechanisms such as denial, regression and repression, which would negatively impact progress. Therefore, embracing differences in intelligence and personality is to ensure flexibility within the therapeutic environment, thus maximising trust and rapport, and continued cohesion between the psychologist and the client.
Aspects of culture, class and social circumstances give psychologists even greater opportunity to draw deeper understanding of their client. Culture and social history is the birth place of a person’s values and beliefs, and this will have significant impact around how the individual will meet any challenge, including rehabilitation (Burton, et al., 2012). Client history can be used as a guide to devise individually accepted therapies that align with a client’s social beliefs and norms. In order to assist a client in achieving a healthy and normal state of being, it is logical that a psychologist must first understand normal and healthy in contrast to abnormal and unhealthy. Brain injury can have a devastating emotional effect on anyone at any age, but perhaps to an older person, the fears of loss of autonomy is even greater than that of a younger person. Understanding normal responses to these stressors, compared to abnormal and extreme responses, will assist the psychologist in monitoring the emotional progress of the client.
The psychologist must also consider the developmental stage of the patient. Here, we are discussing the older client and therefore, their needs are vastly different to say, that of a child. However, as discussed by Burton, et al., (2012), being aged is not a negative circumstance as is often sadly perceived in Western society. It is merely another life stage, bringing with it, requirements to adapt to the physical, emotional and cognitive changes aging may be responsible for. In understanding this, the delivery of therapy types, again, can be adapted to suit each client individually.
In summation, the practice of psychology has great benefit in determining the right application of treatment for the elderly client.
The fundamental aspects of psychology, is what gives this discipline a central platform from which critical factors relating to the overall emotional wellbeing of a person are understood. Due to the high levels of educational expectations, the trained psychologist is a highly qualified individual and expert. Through this expertise, they can seek to reduce the knowledge gap of the client, and in turn, their fears and anxieties, by providing an environment enriched with explanations, strategies, support and therapy, centring around learning to cope with a new set of physical circumstances. It is highly recommended that a psychologist plays a major role in assisting the client to move through the possible emotional effects that may accompany learning to make the necessary adaptations to continue living a valuable
life.
References
1. Burton, Westen and Kowalski (2012) Psychology
2. Cifu, D. S., Kreutzer, J. S., Marwitz, J.H., Rosenthal, J., Englander, J., High, W. (1996), Functional Outcomes of Older Adults With Traumatic Brain Injury: A Prospective, Multicenter Analysis,
3. Psychology Board of Australia, http://www.psychologyboard.gov.au/Registration/General.aspx , http://www.psychologyboard.gov.au/Endorsement.aspx
4. Missouri University School of Health Professions, Department of Health Professions (http://braininjuryeducation.com/Treatment/Psycho/Neruo-Services/
5. Semlyen, J.K., Summers, S. J., Barnes, M. P., (1998), Traumatic Brain Injury, Archives of Physical Medicine and Rehabilitation, Volume 79, Issue 6, June 1998, Pages 678 - 683
6. Woodard, J.L. (2010). Chapter 18 – Geriatric Neuropsychology Assessment, Handbook of Assessment in Clinical Gerontology (Second Edition), pages 461 – 501.