Research Reports - Insight vs readiness: Factors affecting engagement in therapy from the perspectives of adults with TBI and their significant others

Brain Inj. 2012 Jun 27

O'Callaghan A, McAllister L, Wilson L

Introduction: Adults sustain significant, often irreversible impairments
following brain injury. The process they go through coming to terms with these
impairments can seriously interfere with their readiness to engage in
rehabilitation. Aim: This study aimed to look beyond the development of
self-awareness and insight in order to explore the concept of readiness as it
relates to clients' experiences of engaging with therapy. Method: Sixteen
in-depth interviews were conducted with 14 adults with a moderate-severe
traumatic brain injury (TBI) and nine of their significant others. These
participants were asked to speak about the continuum of care they experienced and
the factors that effected their engagement with care. Results: The results of
this study indicated that participants believed their ability to engage in
therapy was related to the degree to which they were aware of and accepted their
impairments and motivated to engage in rehabilitation. Participants reported that
the rate and degree to which they developed awareness varied according to the
type of impairments they experienced (i.e. physical vs cognitive). Participants
also stated that one way to augment their awareness was to compare their new vs
old selves and to compare their recovery to those of others with a similar
impairment. Finally, participants reported that it was important to be able to
access services when they had accepted their impairment and were ready to engage
in therapy. Conclusion: The clinical implications for considering the degree of
awareness of impairments and readiness for engagement in care of an adult with a
moderate-severe TBI are discussed in relation to future services planning.

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