Acquired Brain Injury, Social Work and the Challenges of Personalisation: Table 1

Abstract

Increasing numbers of adults in the UK are living with acquired brain injury (ABI), with those affected requiring immediate medical care and longer-term rehabilitative and social care. Despite their social needs, limited attention has been paid to people with ABI within the social work literature and their needs are also often overlooked in policy and guidance. As a means of highlighting the challenge that ABI presents to statutory social work, this paper will start by outlining the common characteristics of ABI and consider the (limited) relevant policy guidance. The particular difficulties of reconciling the needs of people with ABI with the prevailing orthodoxies of personalisation will then be explored, with a particular focus on the mismatch between systems which rest on presumptions autonomy and the circumstances of individuals with ABI—typified by executive dysfunction and lack of insight into their own condition. Composite case studies, drawn from the first author's experiences as a case manager for individuals with ABI, will be used to illustrate the arguments being made. The paper will conclude by considering the knowledge and skills which social workers need in order to better support people with ABI.

A preventable death? A family’s perspective on an adult safeguarding review regarding an adult with traumatic brain injury

“…His lack of insight into his own condition meant that he would not necessarily have answered honestly during assessment. As highlighted in the literature, individuals like Tom need multidisciplinary team working, a tailored treatment approach and this needs to be guided by an experienced neuropsychologist who can allow and plan for the unique difficulties associated with TBI with regard to lack of insight and poor compliance with treatment (Holloway, 2014;Holloway & Fyson, 2015). The difficulties in managing the interactions with these various services supporting Tom can be summed up as being a categorical failure to appreciate the biopsychosocial model of health (Engel, 1980).…”

“…Adult social care need to undertake regular specialist assessments to monitor the health and wellbeing of individuals with TBI (Holloway & Fyson, 2015). It is also imperative that Health and Social work professionals receive better training in understanding the difficulties associated with TBI, particularly with regards to mental capacity and dual diagnosis.…”

Improving Access to Social Care Services Following Acquired Brain Injury: A Needs Analysis

“…substance use services, and criminal justice services (Holloway, 2014). There is only limited research studying the experiences of ABI survivors and their families when interacting with community services post-discharge from hospital (Holloway and Fyson, 2016). The period of discharge from hospital has been criticised for being "fragmented and unsatisfactory for supporting a successful return home" (Piccenna et al, 2016).…”

Social work-generated evidence in traumatic brain injury from 1975 to 2014: A systematic scoping review

“…Social workers play multiple roles in the field of TBI (Carlton & Stephenson, ; Simpson, Simons, & McFadyen, ). These encompass the provision of client and/or family education; counselling or emotional support (Simpson et al., ); assistance in coping with hospitalisation; planning and support during the discharge and community re‐integration process; help with guardianship/compensation issues including capacity assessment (Holloway & Fyson, ); tackling stigma and discrimination; facilitating social supports (Rowlands, ); advocating for/mobilising resources to help individuals and their families meet the long‐term challenge of maintaining community participation (Degeneffe, ); and undertaking policy analysis/working for legislative change (Foster, Tilse, & Flemming, ).…”