Psychosocial Changes after concussion/TBI

Psychosocial Changes after concussion/TBI


let’s talk about some of the changes
that a person might experience psychosocially after a traumatic brain injury social cues are something that we all
kind of take for granted and use all the time and don’t even really think about
but when you have trouble understanding other people’s social cues or using them
it can be really difficult a social cue might be just for an example looking at your watch when you’re in a hurry or need to go or into conversation it might
be looking at the door when you’re expecting someone else to come in for a
student a social cue might be a teacher turns off the lights when it everyone in
the classroom is supposed to be quiet so some simple things to do for someone who
has trouble with social cues would be to be really concrete and specific and what
you’re trying to communicate so for that teacher shhh everybody’s going to be quiet
now we’re going to have quiet time doing that along with turning off the lights
can really help to make that a really solid communication for everybody in the
classroom – for adults having a meeting and saying you know I only have one hour
and I’ve got to go at this time but I love to catch up with you later or we’ll
we’ll do a follow up we’ll send everybody notes when we’re done having
having that agreed on plan is not just helpful to that person it helps
everybody else to know you know when they when they need to go dealing with an over stimulating
environment now I think that’s one where I would really recommend the use of the
symptom tracker there’s another video in the series where we talk about how to
use it but basically it’s just a really great way to keep track of symptoms and
what causes them what’s going on at the time how you dealt with them and if it
worked or not and then after you get that information you start to see what
what can improve the situation so an overstimulating environment might be
for a person for an adult in the workplace a busy office with people
coming and going meetings in different rooms somebody may be in the next office
on a really loud conference call and when you’re over stimulated by that it’s
so hard to be productive and to focus on what you’re doing a good way to deal
with that could just be putting a note on the door in a meeting on a call just
closing out some of that noise and closing out some of those interruptions
so people can understand what what you’re doing and why you’re doing it and
you’ll be available in another hour or you’ll be you’ll be available when
you’re finished with that in the experience for students and maybe a busy crowded cafeteria they could have lunch in another place they could sit in a
quieter section in a cafeteria have lunch at a slightly different time there
are easy ways to make some changes for that student to have an easier time with that emotional lability so that is when a person has an unexpected and
inappropriate for the circumstance emotional expression so they’re crying
when something’s funny or happy they’re laughing when they’re at a funeral when
something’s really sad or serious it’s just completely the opposite of what you
expect I think one of the very best things to do with that situation is to
acknowledge it very briefly you know this is part of the injury and you know
I don’t mean to do that let’s just get back to what we were doing it can really
help to make people understand a little more what’s going on and realize they
don’t need to to also have a big reaction to that emotion that’s being
expressed it’s it’s it helps sort of deflect the the situation and move on to
something else when someone has a lack of awareness of their deficits whether
that’s a lack of awareness of a physical change that they may have experienced
and need for assistance in the classroom or socially really all areas of your
life can be affected by brain injury but when someone doesn’t understand how
affected they are or how many different types of deficits they have that can be
really it can be really hard helping somebody with what you can see that they need help with and pointing it out in a very gentle way in a way that you would
like to be spoken to if it were you can go a long way I see you’re having
trouble with this let me let me let me do this with this be helpful is
really a nice way to help somebody who might not realize they can’t they can’t
quite do what they were doing before depression and anger it makes a lot of
sense that if somebody didn’t have an injury they’ve acquired a disability and
they’re dealing with a whole new way of doing things might be really upset about
that it’s only common sense it’s only it’s only fair that they would be
able to experience that feeling and for other people to understand it I think we
sometimes forget is that not just adults but even kids can be depressed even kids
can have that anger and that frustration of knowing that it could do something
before and now they can’t and there’s a bit of I think there’s a bit of grief
and loss in dealing with that change and then they can have the chance to create
some new ways to cope with it and to deal with it impaired self-control so we really kind
of associate self-control impulse control poor decision-making with
teenagers and self-control and impulse control and executive functioning and
thinking about the outcome and consequences of your actions
really is something that is controlled by your brain and when
someone has a frontal lobe injury in particular they might have changes in
their ability to think about consequences in long-term
with their actions so knowing this and knowing that it’s unintentional and a
change that occurs in the brain can really help it is something that can
cause problems either in communicating or in the workplace or in relationships
and helping somebody to understand that’s important I think with sexual
behavior and disinhibition the important thing to understand is that when someone
is sexually inappropriate either with things that they say or the way that
they may dress for a meeting or coming to something
for example dressed inappropriately for the situation don’t like dress for a
night out but coming to a serious business meeting when these things
happen it’s not necessarily anything that’s meant to be aggressive or based
on sexuality it’s really just an example of the disinhibition similar to the
impulse control is controlled by the brain so where their brain should have a
filter saying no this is not appropriate for this time there they’re working
without that limited motivation and initiation this would be when a person
might look especially student in the classroom to be lazy to not be trying to
not care and I think one of the ways that can best help someone like that is
to acknowledge you know I’ve noticed since your injury and that you’re having
trouble with this big project or this big event that you’re working on can I
help you break it down break it down into smaller parts and sort of check in
with them on the first steps and maybe having a little hands-on help with that
first piece of getting started sometimes that initiation is just going
to make it you know that one piece they have to get over that hurdle too
to start something an intensification of pre-existing behaviors or disabilities
so it goes without saying that if somebody already is having trouble in
one area maybe they already are a procrastinator maybe they already get
upset easily over stimulated by certain environments that with the injury
working with an injured brain it might be experiencing lots of these changes
and difficulties that those might be exacerbated by the injury they might
they might have some of the same problems after the injury that are
intensified thank you very much

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