Don Mahan, MSW, is the Director Of Social Work for the Neurologic Rehabilitation Institute at Brookhaven Hospital and Ron Broughton, M Ed, LPC, is the hospital’s Chief Clinical Officer.
Moderator: Don, as the program coordinator, how much involvement do you have with patients?
Don:I am very involved with our patients through the planning of daily activities. These activities range from educational groups to recreational outings. I also conduct psychoeducational and process groups throughout the week along with individual therapy sessions. While I am not the primary therapist for all of our patients, I do have daily contact with everyone. My door is always open for our patients and their needs.
Moderator: Ron, as chief clinical officer, what is the extent of your participation with patients?
Ron: As CCO, I have significant involvement with the patients through the treatment team process. In addition, my involvement is reflected in program development, staff trainings, and researching best practices for the brain injury population. When indicated, I become involved with an individual patient through staffing and consultation with their primary therapist, and at times through interaction with the patients themselves on an individual basis.
Moderator: Don, why did you choose to work with people who have brain injuries?
Don: With my education and the increase in traumatic brain injuries, I have been drawn to this population. Being an Air Force veteran, an area that especially moves me is the increase in brain injuries within our military population and the affect it can have on their families.
Moderator: Ron, what motivates you to help individuals with a traumatic brain injury?
Ron: I chose to work with this population because of the unique challenge it presents. In addition, the community need for these types of programs has increased over the years due to the Iraq War and other factors.
Moderator: Don, what are some of the challenges that you face in helping someone with a severe brain injury?
Don: One area that is extremely challenging with a brain injury patient is that of impulse control. Prior to the injury, the individual may have been a calm peaceful person. After the injury, the individual may develop outbursts of anger resulting in physical or verbal aggression. Cognitive processing becomes slower, causing confusion and frustration. Working with the patient through the relearning process can be very difficult. Another area that is very challenging is watching and working with the patient and their family as they go through the mourning process due to the loss of loved ones as they knew them.
Moderator: Ron, what are some of the complexities you have encountered when helping patients with severe brain injury?
Ron: One major challenge is the memory loss experienced by those with a severe brain injury. In other words, as you work with the patient toward recovery, much of the effort is dedicated to assisting the person in using compensatory strategies related to their memory. Another major challenge is assisting the patient in managing their frustration related to memory and identity problems. In many cases, prior to the injury, the person had no memory issues and of course had an established identity as to who they were and where they were going; the brain injury changes these innate assets and skills they once used without a second thought, resulting in significant effort on their part. This in turn affects their identity as a person and an emotional component emerges that requires intervention.
Moderator: Don, in your opinion, what is the most unique aspect of NRI’s programs?
Don: By far the most unique aspect of NRI’s programs is the team approach. With our team of professionals an individual treatment plan can be developed
to assist the patient through recovery. This team meets every week to measure the patient’s progress and review treatment plans. With the input of the psychotherapist, occupational therapist, speech-language therapist, medical doctor, psychiatrist, job coach, recreational therapist, mental health technicians, and nursing staff, treatment plans are reviewed and adjusted to best meet the needs of the patient.
Moderator: Ron, what distinct attribute do you feel makes NRI’s programs special?
Ron: One unique aspect among many is the team itself. We have a solid group composed of a doctor for medication management, occupational therapy, speech-language therapy, recreational therapist, psychotherapist and a job coach. Team members work together for the recovery of the patient and at the same time make sure that the patient’s needs are met via their specialty discipline. (Sentence deleted. EG)
Moderator: Don, what is one of your most memorable success stories?
Don: Memories are made every day at NRI, from the patient who is now able to feed herself to the one who now remembers his little girl’s name. Success can come in very small steps. The greatest success story would have to be that of an individual who was once assaulted and left for dead. The family was told he would not recover. Throughout his recovery he battled anger, depression, loss of identity, inability to communicate, alcohol abuse, decreased cognition and a decrease in motor skills. This patient, after working in groups and individual therapy sessions, is now in a community setting where he is closer to his family, working on his education and will soon be looking for employment. Again, while this is one of the greatest success stories, the most memorable stories come from the little things. It’s almost like the pride that comes in watching your child take their first steps. Recovery and growth are possible through these little steps.
Moderator: Ron, is there a story of recovery that sticks out in your mind?
Ron: My most memorable success story relates to a patient that came through our program a couple of years ago. The patient struggled with his brain injury behaviorally, which included frequent anger outbursts, destruction of property and attacking others. After significant work via medication management, various group therapies and individual therapy, the patient was able to return to a community placement near his home.
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