This document provides information about living with a traumatic brain injury (TBI). It discusses some of the challenges of TBI such as changes to physical and cognitive abilities. It outlines strategies for treatment and habilitation including accurate diagnosis, establishing support systems, medication management, and activities to aid recovery. Effective treatment involves considering an individual's stage of change and may incorporate therapies like cognitive behavioral therapy, music therapy, and group activities. The goal is to create new pathways for an improved life despite cognitive deficits from brain injury.

1. TBI-Traumatic Brain Injury:
It does NOT have to be the End!
(Creating new pathways for an improved life).
CREATED BY:
D O V I E A . G O R D O N - M A F P, B A
F O R E N S I C P S Y C H O L O G Y P R O F E S S I O N A L

2. Disclaimer
For the purpose of learning to now live with brain injuries and cognitive
deficits, I would not allow this Power Point to be edited for grammatical
correctness and order. I made that conscious decision because the world needs
to know that it is perfectly okay to not be politically correct. There is nothing
politically correct about brain injuries and therefore, I have been learning not to
make apologies for how my brain process information and transmits it onto
paper.
Therefore,
Enjoy,
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3. Introduction
Purpose: Sharing this information is from a personal/professional
position based on experience(s).
I spent the last several years obtaining degrees in psychology and clinical mental health
counseling in the hot pursuit of becoming a licensed therapist. But in September of
2014, all of that changed as I was sitting a Red Light on I-17 exit and Peoria avenue in
Glendale, AZ when I was rear-ended by a driver that was on his phone messaging his
significant other.
The normal life as I once knew it in the realm of (physical capabilities, neurologically,
neurocognitive, psychologically, personally, professionally changed forever in that spit
second of the other driver making a poor choice while driving.
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4. Introduction cont.
Seeking medical attention and neuro assessments are after being physically involved in
an accident. For decades on-end, there has been stigma surrounding individuals for
seeking and needing treatment for psychological trauma regardless of the severity.
At the time of the auto accident, I was in the of my second masters degree in clinical
mental health counseling and enjoying every step of the way, at least most of the time.
Within two to three weeks after the auto accident, I began to experience a rapid decline
in my speech processes, muscle control of my limbs, lapses in time, blank stares,
fragmented thoughts, etc.
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5. Introduction cont.
Although I spent a significant amount of time working in the behavioral health/mental
health field, I did not realize most of the challenges would come in ways that I could
not have even imaged.
I immediately began to have many discussions with my PCP and make referral requests
for the specialist that we both felt was a need at the time.
When I decided to share with others in my personal life as well as professional life, the
responses were pretty unfavorable because of the stigma that society created for
individuals seeking needed treatment.
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6. Introduction cont.
However, I decided to provided this food for thought to those that questioned my
decision to request referrals to see a therapist that specialized in trauma/brain injuries
and PTSD.
Food for thought: To go to school for years to become a licensed
therapist in order to provide treatment to others. How could I expect
others to trust my therapeutic position and treatment practices if I do not
entrust therapist that have gone before me to provide me with the
therapeutic services that I need to recover from the neurocognitive brain
injuries that were sustained in the auto accident.
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7. Learning to Live with Brain Injuries &
Neurocognitive Deficits
Everything and Everyone in the life changes!.
First greatest challenge that I witnessed and experienced as I proceeded
through my healing and wholeness process, is that denial and refusal to
accept the major changes to the life of a loved one.
The second greatest challenge on the journey of healing and wholeness,
was and at times, still is; associates, acquaintances, and family members
continue the attempts to treat me as if I have no mild cognitive
impairments, memory loss experiences, fragmented thoughts at times, or
my pause button pushed and everything mentally and orally goes blank.
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8. Challenges to Effective Treatment
• When family members, friends, and acquaintances refuse to accept the changes that
no one has control over, it can have a profound negative impact on the outcome of the
loved one’s treatment.
• When family members will not attend medical or therapeutic appointments to gain
understanding of the life of someone with brain injuries and neurocognitive deficits.
• Doing research to gain an understanding of the medications that the loved one has to
take daily as part of treatment.
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9. Learning to face the dark side
of traumatized emotions
• Anger
• Bitterness
• Wrath
• Hurt
• Pain
• Hatred
• Despair
• Loneliness
• And a tremendous amount of others that will appear at various stages of the healing and
wholeness journey.
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10. Some Damages
that can be caused by others
TEXTING & DRIVING
• Frontal Lobe Syndrome
• Executive Function deficit
• Memory Loss
• Moderate to severe anxiety
• Moderate to sever depression
• ADHD
• Post-traumatic Stress Disorder PTSD
• Mild Cognitive Impairment (MCI)
• Involuntary muscle movement
• Seizures
• Sciatica
• TMJ of the jaw joint
• Chronic Pain
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11. Definition of Traumatic Brain Injury
(TBI)
• According to (Gregory, 2007, p. 457-458),
traumatic brain injury or TBI has been termed
an inclusive term that encompasses everything
from a “mild” concussion to severe brain injury
(Bigler, 1990).
• However, TBI is most commonly the
consequence of a blow to the head, and
concussion is probably the Most common form
of TBI(Gregory, 2007, p. 457-458).
.
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12. FRONTAL LOBE DYSFUNCTION
• Nauta (1971) summarized the effects of frontal lobe dysfunction as a “derangement of
behavioral programming.”
• Motivational-like problems that involves a decrease in spontaneity, a decreased in
productivity, a reduced rate of behavior, and also a lack of initiative
• Challenges in making mental shifts and perseveration of activities and response
• Problems in stopping that are often described as impulsivity, overreactivity, and difficulty in
holding back a wrong or unwanted response
Deficits in self-awareness that resulted in an inability to perceive performance errors or to size
up social situations
A concrete attitude (Goldstein, 194) in which objects, experiences, and behavior are all taken
at their most obvious face value (Gregory, 2007, p. 457-458).
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13. The Four Lobes
• Frontal Lobe
• The anterior portion of the cerebral
cortex, rostral to the parietal lobe
and dorsal to the temporal lobe
• Occipital Lobe
• (ok sip I tul) The region of the
cerebral cortex caudal to the parietal
and temporal lobes
(Carlson, 2010, p. 85-86)
• Parietal Lobe
• (pa rye I tul) The region of the
cerebral cortex caudal to the frontal
lobe and dorsal to the temporal lobe
• Temporal Lobe
• (tem por ul) The region of the
cerebral cortex rostral to the
occipital lobe and ventral to the
parietal and frontal lobes
(Carlson, 2010, p. 85-86)
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14. Brain Image and Segments
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15. CDC STATISTICS
CDC
Based on previous research, in
2009, the Center for Disease
Control (CDC) released their
latest statistics on Brain injury.
(Brain Injury Association of America, March 18,
2013, para. 1)
• 1.1million were identified in
office-based physicians
• 84,000 in outpatient
departments
• 2.1 million in emergency
departments (ED)
• 3000,000 in hospitalization
records
• 53, 000 died (Coronado et. Al.
20120
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16. Accurate Diagnosis
can include but are not limited to
• Neuropsychological Tests
• Lab work
• MRI-full head scan
• EEG
• EMG
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17. Habilitation
(Follow-through at Home)
Create a list of Crisis contacts
• People you know
• Call-A-Nurse
• Behavioral health crisis hotline
• Establish an Emergency Transportation
contact person
Contacts
• Setup auto refill at pharmacy
• Utilize desktop calendar for appointments
• Set alarms on phone, computer, and
watch for medications times
• Establish ADA transportation setup through
Phoenix
• Establish telephone calls for medication
reminder as well as for meal
preparations
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18. Self-Habilitation , cont.
IN-HOME
• Create a time schedule chart based on a 24-
hour time period
• Create a detail list/outline of previous daily
routines and activities
• Now, because of the changes in your life;
create a NEW daily activities
• Being and staying consistent with all medical
appointments
• Taking medications on time daily
• Attending all support groups that are apart of
the treatment plan
• Continual research on new updates
• At least every six months, discuss a
medication evaluation with the PCP or sooner
if any negative changes are noticed
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19. Self-Habilitation, cont.
• Wash Face for rejuvenation
• Shower or bathe often-for stress relief
• Drink plenty of water, juice, and other liquids
• Go outside for at least 15 minutes in the
morning, afternoon, and evening.
• Create a collection of comedy
• Read comic books
• Contact with greenery
• Enjoy puzzles in every form imaginable
ASK FOR WHAT YOU
NEED
&
HELP WHEN YOU
NEED IT!
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20. Effective Treatment Planning
Effective treatment planning can consist of, but not be limited to the following:
• Collection of all medical and behavioral health records and Collateral data
• Rational Emotive Behavioral Therapy (REBT)
• Play Therapy
• Gestalt Therapy
• Occupation Therapy
• Music Therapy
• Cognitive Behavior Therapy (CBT)
• Adlerian Therapy
• Group
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21. STAGES OF CHANGE
•In this stage,
people see no need
to change. They
may be
involuntary
clients, seeking
help because of a
court order or
family pressure.
Precontemplation
• Individuals that are
in this stage recognize
that hey have
difficulties but have
not made a
commitment to take
action needed for
change.
Contemplation
•Clients at this
point, have
decided to change
and have even
taken some small
steps toward
change.
Preparation
• In the action stage,
people are now
motivated and
committed to make
changes. They exert
effort over time to
accomplish those
changes.
Action
•People act in ways
that are likely to
maintain and
continue their
positive changes
and avoid relapse.
Maintenance
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22. Ten Step Change Processes
1) Consciousness raising
2) Catharsis/dramatic relief
3) Self-reevaluation
4) Environmental reevaluation
5) Self-liberation
6) Social liberation
7) Counterconditioning
8) Stimulus control
9) Contingency management
10) Helping relationships (Prochaska & Norcross, 2003, pp. 516-517).
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23. Group Activities for TBI Patients
• Arts and Crafts Therapy
• Hand painting
• Brush painting
• Pottery
• Water activities
• Crocheting
• Knitting
• Needle threading diagrams
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24. Brain Activities
For Brain Injury Patients
• Reading a loud daily unfamiliar material
• Read Poetry-(VARIETY)
• Mathematical equations and tables (+, -, x, and /)
• Oral Grocery store list (A-Z)
• Naming of Continents
• Countries
• Automobiles
• Foods
• Specific things (A-Z) Alphabetical order.
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25. BRAIN ACTIVITIES cont.
Left & Right
LEFT BRAIN-BRAIN
ACTIVITIES
• Word Search puzzles
• Spot the difference
• Numerical Signs
• Spatial: Tetris
• rubix cube
• Board games, etc.
RIGHT BRAIN-BRAIN
ACTIVITIES
• Jacks: with jacks and the ball
• Handheld puzzles
• Sequence games & activities
• Hidden pictures
• Spot the difference
• Solitaire-any version
• Jewel Quest-all versions, etc.
• .
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26. References
• Source: http://www.ncbi.nlm.nih.gov/pubmed/23127680
• Brain Injury Association of America. (March 18, 2013). http://www.biausa.org/announcements/new-
data-shows-3-5-million-people-sustain-a-tbi-each-year
• Carlson, N. R. (2010). Structure of the nervous system. In Physiology of behavior (10th ed., pp. 85-
86). Boston, MA: Allyn & Bacon.
• Gregory, R. J. (2007). Neuropsychological assessment and screening. In Psychological testing (5th
ed., pp. 457-458). Boston, MA: Pearson Education.
• Prochaska, J. O., & Norcross, J. C. (2003). Systems of psychotherapy: A transtheoretical analysis
(5th ed.). Pacific Grove, CA: Brooks/Cole
•
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