Findings suggest that, while TBI is a lifelong problem, its impact is most dramatic in the domain of QOL, where a complex interaction occurs between injury factors, cognition, and personality.

Traumatic brain injury is a lifelong problem, compromising the individual's capacity to meet developmental expectations across a wide range of functional domains.

Adult outcome from childhood brain injury is largely unknown, and health professionals have minimal evidence available to inform families about their child's long-term prognosis. This study aimed to investigate long-term outcomes in this group, focusing on quality of life (QOL) and the injury, developmental, and environmental factors that influence this domain, using a retrospective and cross-sectional design. The sample was ascertained via medical record audit at the Royal Children's Hospital, Melbourne, Australia, and included 130 adult survivors of child traumatic brain injury (TBI) (84 men). Participants were 18-42 years at evaluation (mean = 23.2, SD = 3.3) and completed questionnaires regarding QOL and educational, employment, and psychological status. Analysis of variance, chi-square, and regression were employed to assess group differences and predictors of outcome. While most adult survivors of childhood TBI rated their QOL as intact, 17% of the sample reported poor QOL. Poor QOL was more likely with low levels of perceived independence, severe TBI, younger age at injury, failure to complete high school, and psychological problems. In conclusion, QOL in adult survivors of childhood TBI is better than expected and closely associated with both injury and noninjury factors, most consistently with the individual's perception of their level of independence.

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This article discusses points raised by Streeter's article ‘Finding a Balance between Psychological Thinking and Musical Awareness in Music Therapy Theory – a Psychoanalytic Perspective’ (Streeter 1999). Whilst agreeing that ‘psychological thinking’ is essential for the therapist fully to understand and contain the processes in the therapy room, it considers how music itself can bring about integral change within the therapy process. This is considered in terms of more recent developments in psychoanalysis and analytical psychology, as well as from an aesthetic perspective. Finally, it warns of the danger of moving from one ‘absolutist’ position to another within music therapy, and suggests that we as a profession need to be open to listening and learning from a wide range of disciplines, and from each other, in order to enrich our work.