Talk therapy for traumatic brain injuries

This post isn’t going to take the typical treatment format because a wide variety of courses and degrees qualify others to legally provide talk therapy in Ontario. In our first year alone we dealt with psychologists, counselors, and social workers. If you are trying to have your talk therapy covered by extended health benefits it is important to find out what qualifications they will cover treatments with, ours only covers time with psychologists.

I have long been a supporter of talk therapy, I think we all need it at some point to help with different stages of life. That being said, some of the experiences we had this year made me HATE talk therapy. It had nothing to do with what was being discussed and everything to do with the people we were working with. So my number one suggestion would be – please take some time to interview your therapist before you commit to a treatment plan.

Our first round of treatments was separate sessions with psychologists just one month into our life with TBI. Because the team we worked with had very little experience with traumatic brain injuries they were not able to understand where we were coming from and ended up spending time on the wrong things. Jason, the victim of an assault that changed our life, was discharged within 3 sessions because they were certain nothing was wrong and he hadn’t been affected by the experience. The psychologist I was dealing with felt I was too invested in Jason and must be co-dependent.

The issue here is that Jason’s injuries left him with a lack of self awareness that anyone that has experience with TBI should have noticed and approached the treatments differently. If my psychologist was aware of how much care is needed in the early days of TBI they should have set me up with plans for stress relief, ways to approach conversations with Jason etc. instead of seemingly shaming me for being a caregiver. Those first experiences set us back  and delayed our ability to reach out for help again for months.

When Jason entered rehab we were delighted to be offered couples sessions with a social worker. Unfortunately the first social worker we met with was filling in and not well versed in TBI. She dismissed us 30 minutes into a session with the advice that I should get over being upset because symptoms are symptoms and this is our life now. The next session we lasted about 10 minutes because when she asked Jason to list a “stressful event” from the week he wasn’t able to….because you know, he has memory deficits post TBI!

Our third social worker was a gem. She was kind and honest and while she said we did need to learn to work with the symptoms of TBI she offered solutions. She talked through different possible outcomes from decisions we were struggling with. She advised us to have fun again. She was encouraging. Jason and I were both sad to say goodbye to her at the end of rehab and touched when she set us up with tons of groups and contacts in the community to reach out to when we felt we needed help.

I don’t relay our experiences to shame anyone. My point is, this isn’t necessarily a case of more education creating clinicians.  In our experience it came down to their experiences with traumatic brain injury and their time in their career (burnout is a very real issue that may have affected a couple of people we met). Do some research and have some conversations with the people you are thinking of hiring. Ask Brain Injury groups around you if they have anyone they recommend. Talk to other TBI survivors and see if they have anyone they’ve worked well with.  I’m including a link to this article by LifeHacker to discuss some of the steps you should take to find someone to work with.

Finally, I generally like to suggest sticking with one treatment plan until the end to see what a clinician can do for you. But I know how expensive treatments can be and I saw how negatively we were effected by our time with psychologists. So my new suggestion would be if something is striking you as wrong or dismissive of TBI it may be okay to end the sessions and search for a new clinician to work with.

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