Ramifications of traumatic brain injury for sexuality

Davis, Diana L.; Schneider, Lynne Kolton

doi:10.1097/00001199-199005020-00006

Cited by 20 publications

(11 citation statements)

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“…Some professionals felt that training would facilitate communication about sexual issues, which supports findings from the literature [23][24][25]28]. However, the qualitative methodology of this study enabled further insight into the potential pitfalls of training: First, some participants who were aware of training considered it to be of insufficient level.…”

Section: The Complexity Of Sexuality After Tbi and Training Issuessupporting

confidence: 74%

“…Research indicates that professionals may be reluctant to engage service-users in discussions about sexuality after TBI for a number of reasons, including personal embarrassment, lack of knowledge and training, lack of time and resources, believing it is not their responsibility, lack of policy and the lack of a systematic approach to sexual rehabilitation post-TBI [23][24][25]27,28]. Furthermore, research has indicated that professionals tend to take a reactive approach, only addressing it if the service-user raises it first [22,23].…”

Section: Introductionmentioning

confidence: 99%

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Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

Dyer

Nair

2013

Disability and Rehabilitation

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Dyer, Kerry and das Nair, Roshan (2013) Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals. Disability and Rehabilitation, 36 (17 A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. Purpose: Research indicates that although 50-60% of people who have had a traumatic brain injury (TBI) experience changes in sexual functioning, sexuality issues remain largely unaddressed in rehabilitation. This study aimed to explore rehabilitation professionals' perceptions and experiences of discussing sexuality with service-users who have had a TBI. Method: Purposeful sampling was used to recruit 24 participants from two local National Health Service trusts and from a national charity. Four focus groups were conducted with pre-existing groups of professionals, using a semi-structured interview schedule. Focus group data were transcribed verbatim and analysed using thematic analysis. Results: Six main themes were derived from the analysis: (1) sexuality after TBI is a specialist issue; (2) sexuality is a sensitive subject; (3) practicalities of discussing sexuality; (4) roles and responsibilities; (5) dilemmas about risk and vulnerabilities; and (6) organisational and structural issues. Conclusions: Our findings suggest that a more proactive approach to addressing sexuality issues be taken by incorporating sexuality into assessments and by having sexuality information available for service-users. Support for professionals is also needed in the form of the development of policy, on-going training and supervision. Implications for Rehabilitation Rehabilitation professionals find it difficult to deal with issues of sexuality following TBI, and the reasons for this are complex and interrelated.  To provide holistic care, a more proactive approach to addressing sexuality issues should be taken. Professionals do not need to be an expert in sexual issues to open dialogue.  Sexuality discussions should be incorporated into assessments, and written information should be available for service-users. Further training for professionals and organisational policy change is sometimes required to effectively deal with sexuality issues.

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Section: The Complexity Of Sexuality After Tbi and Training Issuessupporting

confidence: 74%

Section: Introductionmentioning

confidence: 99%

Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

Dyer

Nair

2013

Disability and Rehabilitation

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“…Appropriate assessments and interventions that address clients' interpersonal safety needs may be critical to breaking the cycle of violence and abuse in heterosexual as well as homosexual relationships in hospital and community (Kwako et al, 2011;Langlois et al, 2008;Miller & Du Mont, 2000). It would also address some of the high-risk legal and moral conundra that rehabilitation facilities identify in relation to intimate contact by clients (Banja, 1993;Davis & Schneider, 1990). Staff cautionary surveillance should also apply to intimate partners in previously non-abusive relationships, since they have been shown to be at increased risk of verbal abuse, threats of physical violence, and overt aggression due to clients' TBI-related increases in irritability levels, temper outbursts, or alcohol use (Farrer et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Grief, Anger, and Relationality

et al. 2014

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Background: Therapeutic emotion work is performed by health care providers as they manage their own feelings as well as those of colleagues and patients as part of efforts to improve the physical and psychosocial health outcomes of patients. It has yet to be examined within the context of traumatic brain injury rehabilitation. Objective: To evaluate the impact of a research-based theater intervention on emotion work practices of neurorehabilitation staff. Research Design: Data were collected at baseline and at 3 and 12 months postintervention in the inpatient neurorehabilitation units of two rehabilitation hospitals in central urban Canada. Subjects: Participants (N = 33) were recruited from nursing, psychology, allied health, recreational therapy, and chaplaincy. Measures: Naturalistic observations (N = 204.5 hr) of a range of structured and unstructured activities in public and private areas, and semistructured interviews (N = 87) were conducted. Results: Preintervention analysis indicated emotion work practices were characterized by stringent self-management of empathy, suppression of client grief, adeptness with client anger, and discomfort with reactions of family and spouses. Postintervention analysis indicated significant staff changes in a relationality orientation, specifically improvements in outreach to homosexual and heterosexual family care partners, and support for sexual orientation and intimacy expression. No improvements were demonstrated in grief support. Conclusion: Emotion work has yet to be the focus of initiatives to improve neurorehabilitative care. Our findings suggest the dramatic arts are well positioned to improve therapeutic emotion work and effect cultures of best practice. Recommendations are made for interprofessional educational initiatives to improve responses to client grief and potential intimate partner violence.

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“…The therapy with a surrogate is an emotional experience and process in which the survivors receive forms of sexual gratification while relearning social and interpersonal skills and thus improve their quality of life [20]. Inherent in the surrogate process is an emotional experience that is not available in other forms of sexual therapy that can facilitate the opportunity for the survivor to learn new behaviors and to improve verbal and non verbal communication.…”

Section: Discussionmentioning

confidence: 99%

Sex Therapy Surrogate Partners for Individuals with Very Limited Functional Ability Following Traumatic Brain Injury

Aloni¹,

Keren

Katz

2007

Sex Disabil

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The use of surrogate sex therapists for survivors after Traumatic Brain Injury (TBI) who have Very Limited Functional Ability (VLFA) is discussed. It includes the rationale of using surrogate therapy with this population as well as some of the professional and ethical issues that such therapy can evoke. It is suggested that surrogate therapy can provide satisfaction and positive experiences to the restricted lives of some of the VLFA-TBI survivors. The use of surrogate therapy is viewed as a part of the integral rehabilitation process aimed at improving the quality of life and the fulfillment of basic human intimacy needs. Often requiring help in this important area of life, they are not always able to initiate and control emotional behaviors to promote healthy sexual relationship and activity. Surrogate therapy is an activity that can help survivors with TBI monitor and initiate feelings, reactions and motivation in intimate relationships, as well as provide a certain amount of control over their lives. A case study is presented to illustrate the process of sex therapy with a surrogate partner for a VLFA-TBI survivor.

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Ramifications of traumatic brain injury for sexuality

Cited by 20 publications

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Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

Talking about sex after traumatic brain injury: perceptions and experiences of multidisciplinary rehabilitation professionals

Grief, Anger, and Relationality

Sex Therapy Surrogate Partners for Individuals with Very Limited Functional Ability Following Traumatic Brain Injury

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