Information from the Brain Injury Team about the role of each professional
Clinical Psychologist Role
The role of the Clinical Psychologist within the Brain Injury Team focuses on two main areas.
The first relates to some of the common consequences of brain injury, such as difficulties with concentration, memory, organisation and planning. These types of skills are often called “cognitive’’ skills, and it is important to be aware if such difficulties are present so that their impact on daily life can be minimised where possible. For this reason, the Clinical Psychologist will often carry out a “cognitive assessment’’ aimed at identifying those skills which are more difficult and those which are just as good as ever. Identifying strengths is an important part of rehabilitation as they can sometimes be used to work round any difficulties that are present. For difficulties relating to, for example, concentration or memory, there are a number of suggestions that can be made about how to manage them.
Secondly, the Clinical Psychologist is involved in the emotional consequences of head injury. It is usually a very distressing time for individuals and their loved ones, often associated with marked frustration. These feelings can last for a long while, and sometimes people’s quality of life can be markedly affected by depression or anxiety. Clinical Psychology input can help people manage difficulties such as these.
Both cognitive and emotional difficulties have an impact upon family members and loved ones as well as the person who has had the head injury, and part of the role of the Clinical Psychologist is to offer information and support to family members.
The role of the Physiotherapist after any injury is to assess the physical capabilities of a person, e.g. their ability to move their arms and legs and the strength in their muscles.
The Physiotherapist also assesses the ability of the person to transfer, balance and walk looking at the need for a mobility aid and issuing with the appropriate one.
The Physiotherapist will then give tailor made exercise programs designed to work on the areas that the person has difficulties with, e.g. strength, balance, co-ordination.
The Physiotherapist works closely alongside the Occupational Therapist to assess the need for splints or orthotics and to assist the person to return to their normal functional level.
Occupational Therapist Role
The role of the Occupational Therapist is to assess the functional impact of a brain injury on everyday life. A person may experience physical, cognitive, and behavioural and communication difficulties following a brain injury which may impact on their ability to care for themselves return to work or continue leisure / social activities.
The Occupational Therapist may: -
- Help people to learn new ways of doing things, e.g. teaching someone with reduced stamina or fatigue how to conserve energy when performing daily activities.
- Give advice on how the home or workplace environment can be adapted to promote independence, e.g. ensuring wheelchair ramps are installed.
- Provide therapy sessions focusing on functional activities often alongside the Physiotherapist in order to promote rehabilitation of previous skills, e.g. regular practice of functional skills such as having a shower.
- Adapt materials or equipment to enable independence, e.g. adjusting a knife for someone with reduced hand dexterity.
- Assess posture and seating and provide specialist equipment to promote good positioning and functional recovery, e.g. specialist wheelchair, splints.
- Assist a person to integrate back into the community using functional skills, e.g. shopping in the local supermarket, using public transport, returning to leisure or social activities.
- Assist a person back to meaningful occupation; this may involve a return to work, starting a training course or volunteering.
The Occupational Therapist in the Brain Injury Team also runs the Head Injury Group alongside the Clinical Psychologist, and the Vocational Education Group.
Speech and Language Therapist Role
To assess, diagnose and treat oral and written communication problems such as:
- cognitive communication disorders – communication difficulties cause by cognitive impairments
- receptive dysphasia – difficulty in understanding the spoken word
- expressive dysphasia – difficulty in expressing thoughts and ideas
- dysarthria – slurred or unclear speech
- dyspraxia – difficulty with voluntary movements of the mouth, lips and tongue
- dysgraphia – difficulty with writing
- dyslexia – difficulty with reading
The Speech and Language Therapists may also be involved with the provision of communication charts or high-tech communication equipment.
To assess swallowing problems (dysphagia) and make appropriate recommendations. This may include altering food or drink textures, looking at a patient’s positioning or using compensatory strategies. Recommendations made will be regularly reviewed. Patients may be assessed at the swallow (videofluoroscopy) clinic.
In some cases patients may require alternative feeding such as a nasogastric tube (NG) or percutaneuos endoscopic gastrostomy (PEG). Alternative feeding may be required for only a short period of time or if necessary, can be a permanent measure dependent on a patient’s swallow recovery and level of alertness.
When a patient is unable to communicate as they are still in a coma, or coming out of a coma, the Speech and Language Therapists will be involved at the pre-verbal level, for example, in setting up, carrying out and supervising sensory stimulation programmes
Therapy Technician Role
The role of the Therapy Technicians within the Brain Injury Team is to carry out therapy programmes under the guidance of the therapists and team.
To carry out home visits and community visits with the relevant team therapist or on their own.
To liaise with other Multi-disciplinary teams regarding aspects of patient care.