Making Headway Spring 2012

Spring 2012 Edition

MAKING

Bringing positive change in the lives of those affected by Acquired Brain Injury

Spring 2010 Issue

Making Headway is published Making Headway is published by by

Inside Inside

The Neuro-Rehabilitation Introduction to Spring Strategy?

Edition 2 2 Telling Tales: Telling Joan’s Tales Story 3 3 Making the Linda’s MostLarder out of Community Living 4 5 To The Top A Legal of theView World

6 6 ABI Ireland’s Lobby Community Day in Leinster BasedHouse Neuro- 7 Rehabilitation Brain Services Awareness Week 2012 8 8 Rehabilitation Research of Executive Round up Function 10 after Brain Injury 11 1

Welcome to the Spring Edition of Making Headway

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elcome to the late Spring Edition of Making Headway! Spring is a time of renewal, hope and optimism. This year is no exception and fresh on the heels of our most successful Brain Awareness Week ever (featured on page 8) , there’s plenty to feel good about.

This edition contains the inspiring story of brain injury survivor, Ronan (page3), whose own forward-looking attitude has been central to his recovery. We also have a piece from Linda on how blogging her recipes is giving her new found confidence (page 5). We have a guest article from a firm of solicitors, MacMahon Goldrick, who explain the legal complexities of compensation (page 6), and plenty of our usual mix of news, research and features.

Front Cover picture: (L to R):Kieran Loughran, Headway CEO at the Afternoon Tea; Alma O’Grady (Headway Limerick) at the Hunt Museum; Ciarán Nolan and Clodagh McKenna at the Afternoon Tea; Kate Lynch, Noel Kenneally, Carol O’Brien, celebrating National Brain Awareness Week at Headway, Ballincollig (Picure: Tom Doherty); Guests at the Afternoon Tea; Joe Sherlock (Headway Dublin)

I hope you enjoy reading it as much as we have enjoyed putting it together. As ever, if you’d like to contribute articles, stories, interviews, ideas, please email me at stablesr@headway.ie Happy spring and summer!

Richard Stables Editor, Making Headway

Some of the guests at the Afternoon Tea for Headway during Brain Awareness Week

A Message from the Chief Executive As I write this introduction it looks like summertime has arrived. The weather is good, and this can lift everyone’s spirits.

Despite the continuing financial difficulties that beset the nation, we stay optimistic in delivering on our mission to bring “positive change” to the lives of those we serve.

When you scan the horizon for the policies and strategies that are likely to influence the shape and or direction of future service delivery there are two significant documents in the public domain: the National Policy and Strategy for the Provision of Neuro-Rehabilitation Services in Ireland and the recent report entitled “New Directions – Personal Support Services for Adults with Disabilities”.

The Neuro-Rehabilitation Strategy, which we anticipated in our last issue of Making Headway, is disappointingly aspirational. Whilst it is a good summary of an ideal system of service provision, it contains no particular timelined actions and contains little reference to life in the community which, after all, is where most people with brain injury will spend most of their lives.

The New Directions document is particularly relevant to Headway and the work we do. It articulates twelve

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personal supports that should be available for adults with disabilities who receive a person-centred service. The report acknowledges that there is no free-flowing continuum in brain injury services from trauma to community re-engagement anywhere in the country. However, I do believe that Headway performs very well on many of the measures within the geographical areas in which we operate, within the resource constraints. Once again, the report points to the need for greater collaboration in services, not only between voluntary organisations but also across the full range of state services.

On other news, Headway’s National Advisory Group of service users, comprising representatives of service users from Dublin, Cork and Limerick met with the Headway Board in February and a very positive engagement took place. This will become a regular and committed meeting. We are also pressing on with the preparation for accreditation which has at its core person-centredness. Our staff continue to demonstrate great commitment, flexibility and creativity.

Finally, I wish all a good spring and summer.

Kieran

Making Headway

Spring 2012

Telling Tales: Forward Focus Ronan suffered a horrific horse-riding accident shortly before his leaving cert year. Fracturing every bone in his face and with a bleed to his brain, his parents were told to expect the worst. Fifteen years on, and following extensive reconstructive surgery, he has made a recovery which you could describe as almost miraculous. But a recent decision to take a Masters degree in Business Administration (MBA) made him reflect on his head injury and his ability to achieve his goals. He talks in this interview to Headway’s Richard Stables about his forward focus and its importance in his continuing recovery.

When was it that you first started to wonder about how you were doing?

There were a couple of stages. In my physical recovery, about six or seven years after the accident I met someone who had been injured in a motorbike accident. He recommended an osteopath to me who very quickly was able to take away a lot of stiffness and pain in my back which allowed me to focus again on getting physically fit. I’ve worked hard from that point and now I jog regularly. In terms of my mental recovery, it was my girlfriend who suggested that I do a Masters in Business Administration (MBA).

I thought it wasn’t a bad idea but I got to thinking: ok, well tackling an MBA with a head injury is a whole new level of challenge; will my level of ability or concentration be up to it?

So I started thinking about head injury. I’d read in Making Headway about a story of recovery similar to mine, and I thought: I should probably do the course, but will I be able for it? Anyway, I applied for the course, was accepted a week later and before I knew what was going on I was starting an MBA. And did you have any difficulties? MBAs are notoriously intensive courses.

Yes, I did have difficulties concentrating. I found that when someone asked a question, instead of paying attention I was already off on a track of “well I know the answer to this” before the questioner had finished. I’m not sure if I would have had that problem with concentration beforehand, but I’m a creative thinker which can mean you are naturally inclined to hop around the place. No matter how hard I tried to adapt and concentrate, I couldn’t alter this lack of concentration. This gave me pause for thought.

So, what made you come to Headway?

Part of the MBA involved a module of personal development. The idea was to survey people around me and figure out where my key weaknesses are in my professional life. It turned out that I had two areas

I had to work on: Stress and creative problem solving – both these areas were personal weaknesses rather than professional. I honestly didn’t think I had stress, but when I started looking into it I realised I did have stress, not so much to do with work but to do with things like managing money, which I believe people with head injury can sometimes have issues with.

Also, the stress wasn’t allowing me to think through problems. I would make very quick decisions but without thinking through the problem. So that got me thinking about my head injury.

You came to us with questions about your functioning – what did you get out of it?

I found out a lot about my accident. Until then, all I knew was that I had broken bones and a head injury. I had all sorts of false memories of the period immediately after the accident, thinking I’d just had a bang on the head and I was fine. In fact, I’d no idea that months had gone by and I hadn’t a clue where I was.

It was interesting to do the psychological tests and learn about my strengths and weaknesses. I learned that my long term memory and my hearing memory were fine, but my visual processing wasn’t so good which explained why I had difficulty remembering directions for driving. It gave me a lot of information.

Beforehand I had presumed the news would be all bad, but there was a lot of positivity to come out of the assessment. I’d also been experiencing flashbacks to the time of the accident, and those have resolved now.

How has that understanding impacted you?

I don’t know that understanding what happened to me has had a big impact. I think it has had more of an impact for other people. To be honest I think I was a bit immune to it myself- I didn’t even know this information was there. My focus has always the whole time been forward, getting back to school, doing my leaving cert and focusing on the physical recovery.

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Has that forward focus been helpful for you?

Absolutely – I believe it is the reason I made the recovery that I did. I very quickly accepted the situation as it was and sought to make the best of it. Probably more so than anything else, I think that’s why I recovered to the extent I did, no looking back or “sorry is me”. My girlfriend sometimes asks “Do you ever think about what could have been if it didn’t happen?” - I just don’t think like that. I look at me prior to the accident as a curiosity, particularily as I get older. The post-accident Ronan is almost as old as the pre-accident Ronan now, and I find that whole concept very curious.

And what does the future hold?

I’ve finished my MBA, work is going well, I work for a growing company, and I’m getting married later in the year. It’s all good. Exercise is also a big part of my life and I believe the focus on running longer or faster than I have done before is my attempt to control my physical recovery. I was an athlete before the accident.

My next dream is to run the marathon. My longest run this year so far is 18k.

Poems

The head injury is part of who I am. It’s as much as part of me as, say, being Irish. I wouldn’t be who I am without head injury. My short haircut doesn’t hide the scars and I believe it has helped mould me into who I am today. It’s always going to be there. I’m probably now interested in it more than I ever was. I don’t regret it.

I know I’m lucky, I’ve been in clinics and I’ve seen other people who haven’t been as lucky. There’s a lot of hardship for families. My own parents thought I was gone. My heart had stopped; I had MRSA, pneumonia, the works. It was the forward thinking that got me through it I believe.

My forward looking approach - It does work and it is what I’d like to pass on to other people. I don’t believe I would have got better looking backwards or looking back at the accident and focusing on why it happened or what if I’d done this or that . The fact is, it happened.

End of. Now it’s all forward moving whether physically, mentally or career-wise.

Here are two poems from brain injury survivors. Helen McMahon attends our vocational programme in Limerick and Anthony McGann uses our Community Integration service in Dublin.

Flow of Life, by Helen McMahon Like the ebb and flow of the tide Like the crest of a wave Our lives start and end With highs and lows throughout.

The secret is to realise the moment And to treasure them.

Pass on a little kindness And learn from our mistakes.

To all of you who are up Help those who are down.

To those of you who are down Reach out and ask for Help.

Life is getting scary Tragedies do happen Nature is powerful Look for the answers within Peace and Harmony will reign again.

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Is the Head Injury in the past, or something you keep with you?

Headway, by Anthony McGann.

Making Headway

Linda’s Larder

Spring 2012

Linda’s Larder is a new series of food recipies by brain injury survivor, Linda. Headway’s Elisa O’Donovan chats to her about food, blogging and how it helps her recovery.

Tell me a bit about yourself?

My name is Linda. I’m 34, I’m from Blanchardstown and I acquired a brain injury a number of years ago after a road traffic accident. I have always had an interest in cooking ever since I was young. My favourite thing about cooking is seeing the smiles on people’s faces, and empty plates, when I serve them a dish.

Sometimes I find it quite difficult to follow recipes since my brain injury, especially when it comes to exact measurements. I find all the different weight measurements really confusing! Because of this I don’t follow recipes rigidly, and I make up my own style and recipes. I think food should be fun, and should be played around with. My brain injury has probably made me more adventurous when it comes to cooking, and I think this is a good thing!

How did Linda’s Larder come about?

It was Elisa who first suggested it to me. She had arranged to meet me at my house, and I had some of my chicken pasta lunch ready for her when she arrived. Elisa told me that she thought it was better than anything she’d tasted in a restaurant. She was asking me had I ever had professional training as a chef, as she thought the food was that good! It was so great to get that positive feedback from someone.

got from all the staff was so overwhelming, as they seemed to all love my food, especially my nut and chocolate cookies.

Has publishing Linda’s Larder helped you along your individual brain injury journey?

It really has. I think sometimes when you have a brain injury your confidence can be knocked a bit. People don’t understand the difficulties that you face and how much harder things can be. That’s what I like about cooking. It is just me alone in the kitchen. I can take my own pace, and take things slow.

Having such positive feedback from Elisa, and seeing the blog on screen has given me a huge confidence boost. I feel that there are opportunities out there for me, and that I have talents and skills that I should nurture.

You can read this mouthwatering recipe and more of Linda’s Larder at her blog at www.headway.ie/brainblog/author/lindaslarder/

We started talking about food and cooking, and Elisa suggested that I write a recipe blog for Headway’s website, and Linda’s Larder was born!

How did it feel when you got your blog published?

I was very excited about starting the food blog, as I thought it would be a great platform for me to get my ideas and recipes out there to a wider audience.

It has always been my dream to open up my own cafe, and this felt like a first step to being recognised as a good chef.

Elisa came out to my house one Friday afternoon, and I had cooked three dishes for her. We took pictures and Elisa brought all the food back to the Headway offices for taste testing. The feedback I

One of Linda’s recipes, the scrumptious Chocolate Nut Cookies

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A Legal View

by MacMahon Goldrick Solicitors

Jessica Goldrick

Any claim for compensation arising from a brain injury can be complex and a number of issues arise that are novel or unique to this type of injury. Many of these issues arise due to the complexity and uniqueness of the human brain. Further issues arise from the fact that it can be difficult in the short term to establish the consequences that arise from a brain injury. Indeed problems can develop some time after the initial brain injury.

Every case for personal injury requires the use of expert witnesses in order to provide evidence relating to the consequences of such an injury. A number of experts are required in the preparation of brain injury cases that are not normally used in a standard personal injury case. These for example can include neurologists, neurosurgeons, neuropsychologists and rehabilitation consultants.

The brain is a unique organ and the effect of brain injury will differ depending on the area of the brain affected and the individual concerned. Different people can react differently to a similar injury. From a legal and medical perspective, a one size fits all approach is not appropriate where the brain is concerned and a case should be built around the individual taking the case. In order to deal with late onset difficulties, a solicitor should have regular meetings with the client in order to record any changes that the person experiences. The solicitor should also ensure that all of the experts are updated with new instructions and that reports are updated to take into consideration any changes that the person experiences. A solicitor should be aware of all of the physical, cognitive or emotional changes arising from a brain injury.

The legal process can be time consuming and this is particularly the case in brain injury cases. The consequences arising from a brain injury are not always immediate and it can take a period of time before a clear medical prognosis becomes available.

A case can finish in one of two ways. It can settle or it can go to hearing, in which case a Judge sitting alone will hear the evidence and make a decision as to whether or not to award any compensation and also the amount of the compensation. When cases settle, they tend to settle at an advanced stage when a lot of preparatory work has already been done. Any settlement reached or Court judgment (subject to appeal) is final and it cannot be revisited afterwards

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even if new medical evidence subsequently comes to light. This is why it is important that as clear a medical prognosis as is likely to be available is secured before any brain injury case is heard or settled. It is helpful if the solicitor provides a guideline to his/her client at the beginning of the case as to the steps involved in taking a case.

Another issue that is unique to brain injury cases is that brain injuries do not always show up on MRI scans or other scans. So called “mild” traumatic brain injury can have severe consequences for the individual concerned and this type of injury can often go undetected in standard scans. This is where neuropsychologists and rehabilitative doctors have an important role to play as they can provide evidence as to the affect that the injury has had on an individual and whether that injury is consistent with a brain injury. Scanning technologies are improving all of the time and it is to be hoped that in future “mild” traumatic brain injuries will be discernible in scans but this is not a realistic option at present.

It is regularly the case that the Defendant in a case will have insurance and in these circumstances the insurance company appoints a solicitor to deal with the case. The insurance company and not the Defendant will have to pay any compensation.

An insurance claims handler will work on the case in conjunction with the solicitor. The more the insurance claims handler and the Defendant’s solicitor know about brain injury the better as it will enable them to appoint the appropriate experts and value the case properly. This is important as it avoids delays in having the case heard and it will also increase the likelihood that any settlement offer is an appropriate amount. In some instances it is up to the claimant’s solicitor to “educate” the Defendant’s solicitor as to the nature and seriousness of the brain injury and he can do this by ensuring that all information relevant to the brain injury is disclosed

Making Headway during the pleadings stage. Pleadings are written documents that are exchanged between a Claimant and a Defendant in legal proceedings.

If the case does go to Court, a Judge will hear the case and the relevant evidence. The Judge may or may not have a lot of experience in hearing brain injury cases. It will be the responsibility of the claimant’s legal team to inform the Judge as to the seriousness of the brain injury and its consequences. When a case is being taken, it is useful for the person who has suffered a brain injury to keep a diary recording their experiences of living with a brain injury. It is also beneficial if a close family member does the same thing. This can be useful in providing his/her legal team with a better understanding of the effect

Spring 2012

that the injury has had on their day to day life.

The most important thing for an individual who is taking a case following a brain injury is that they take care of their health and avail of whatever rehabilitation services that are available. It is important that they put their energies into the rehabilitation process. Returning to work (if this is possible) can also be an important factor in assisting someone in their recovery. If someone feels that they are able to return to work before their case is heard, they should, subject to medical advice, make efforts to do so. It may also provide useful information as to the likelihood of a full time return to work or indeed whether an alternative career path should be pursued.

Lobby Day in Leinster House This February, Headway service users and staff from centres around the country joined charities from across the neurological sector to lobby TDs and Senators in Dáil Éireann. The aim of the day was to make public representatives aware of the important role played by service providers such as Headway in the lives of the thousands of people with neurological conditions in Ireland.

Over 45 TDs and Senators attended the briefing, during which representatives heard that: • Just one in six people requiring specialist rehabilitation for neurological conditions are receiving the services they need to rebuild their lives.

• According to the Neurological Alliance of Ireland (NAI), community services provided by neurological charities are “in crisis” following funding cuts in recent years of up to 12%.

• The health service’s own data shows that in 2010 just 2,510 out of 15,000 people requiring specialist rehabilitation services for conditions such as acquired brain injury, stroke, spinal cord injury, MS and Parkinson’s actually received vital treatment.

Neurological Alliance of Ireland chairman, Chris Macey said: “This is like Russian Roulette in reverse.

For every person who receives the services that could enable them get their life back maybe from a brain injury sustained in a car crash, from a stroke, or from the onset of a serious neurological condition, five will be left with no service and in many cases no hope at all.”

Headway Limerick Service Users Tom Griffin and Robert Edmonds at Leinster House

Headway was well represented at the event and would like to thank the service users and staff who turned out on the day to help get the message across, some of whom had travelled long distances to be there. Thanks to Kay, Phil, Michael, Tom, Robert, David and Alan.

The group of representatives from Headway and the Neurological Alliance of Ireland

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Congratulations!

Earlier this year, a number of trainees in the Clondalkin Rehabilitative Training programme successfully completed FETAC Level 3 modules in FETAC Personal & Interpersonal Skills and FETAC Food and Cookery. Every person did Trojan work towards completing their folders.

communicate assertively. All of these skills are necessary for many work, social and life situations.

Congratulations to Alan Byrne, Michael Comisky, David Kennard, Dean Courtney and Kay O’ Brien.

The aim of the Food and Cookery module was to develop the skills needed to prepare and serve a The Personal and Interpersonal Skills module variety of meals and to work as part of a team. The enabled the learners to develop a sense of self- people who were successful at completing this knowledge & self-awareness, to undersand module were Dean Courtney and Derek Cross. and demonstrate decision making skills and

Singing our Hearts Out Service users from Headway Cork recently took were taken for us by Marcin Lewandowski from part in a singing workshop with Cork Sacred Harp www.soundofphotography.com.

Community Singers. Sacred Harp is based on a 300 year old style of singing called Shape Note and is all about people coming together as one to express themselves through song.

“It was a very powerful, fun and uplifting experience” commented Headway’s Paula Larkin.

The workshop took place at the Camden Palace Hotel, which is a volunteer-run artist and community space in Cork City (see www.camdenpalacehotel. org/). More information about Sacred Harp can be found at http://corksacredharp.com. The photos

The Sacred Harp Singing Workshop photo by www.soundofphotography.com

Brain Awareness Week 2012

Brain Awareness Week ran this year from March 5th to 11th. As in previous years, it saw Headway service users, families and staff pull together in a huge number of activities to help in the quest to raise awareness about brain injury and the services and supports available.

In Dublin, the week kicked off in style with guest presenter, TV Chef and food writer Clodagh McKenna joining us to host our Afternoon Tea Party which was held in the Davenport Hotel. An impressive array of goodies was on offer, prepared by the Headway staff for the one hundred guests. Clodagh entertained us with her cupcake icing demonstration and some useful gastronomic tips. The event also managed to raise over €800.

In the Rehabilitative Training service in Finglas, Dublin a grand total of € 730 was raised by canteen staff in Colaiste Ide and users of the service who held a raffle and sold their handmade jewellery and greetings cards. In between classes and bouts of fundraising, the service users also managed time to give talks to

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several groups of students. Congratulations to all!

There were information stands aplenty, in Liffey Valley shopping centre; Stephen’s Green shopping centre; Blanchardstown Hospital; the Mater Hospital; Beaumont Hospital and in Clondalkin.

In Cork, Headway’s psychological and social work services organised a stand at the Mercy Hospital which was manned by Headway staff and by family members of service users. The service also held an information/coffee morning for staff members from local family resources centres. Along with tea and cake, they provided a general overview of ABI and Headway services. Yet more information was available through a stand in CUH and a talk to a secondary school.

Making Headway

Spring 2012

In Limerick, culture was the order of the week, as the third annual art exhibition in the Hunt Museum showcased the creative talents of the Headway artists. In addition, there were presentations and information stands at the train station and the Crescent shopping centre and in UL. At Dunnes Stores in Childers Road Headway clients sold over three hundred trolley tokens to raise awareness.

A talk about brain injury to professionals was also given from Headway’s Limerick centre in Steamboat Quay.

Karen Foley from Acquired Brain Injury Ireland and Meadhbh Lysaght from Beaumont Hospital at the Information Stand at Beaumont Hospital

The events during the week weren’t just limited to local community activities. Some serious notes were struck during the week by the National Conference hosted by the Neurological Alliance of Ireland, entitled “Securing Resources for Neurological Care and Rehabilitation in a Recession”.

Opening the conference, Mr Chris Macey, Chair of NAI, spoke of the effectiveness of non statutory organisations as advocates for change, as service providers and as key partners in transforming neurological care services. This was followed by presentations from the clinical directors of each of the national programmes in Stroke, Neurology, Rehabilitation and Epilepsy. The afternoon session focused on supporting non statutory organisations in lobbying and campaigning with presentations from Amnesty and the Alzheimer Society of Ireland.

Sean and Angela Young enjoying the treats at the Afternoon Tea

In Cobh, the Day Service attendees took part in a tournament of Boccia, a popular sport with wheelchair users based on the French game, Boules.

Not to be outdone, the clients in the Mallow Day Service went on an outing to play bowls. In Carlow, a joint coffee morning held with Brainwave, the Epilepsy organsation ensured that everyone was getting enough refreshment whilst learning about brain injury and epilepsy.

With such a concentrated amount of activity out and about in all the local communities where Headway is based, we are confident that with each passing year of Brain Awareness Week, the message keeps spreading about brain injury and the unique challenges it poses.

Thanks to everyone who participated during the week and supported us in helping people become more aware of brain injury. Keep spreading the word!

Dog Track Fundraiser On the night of the 22nd March, Headway Cork staff and clients held a fundraising night in the dog track. A great night was had by all and some even managed to go home with more money than they came out with! While some people “studied the form” carefully and meticulously before placing their bets, others chose their dogs based on their name, where they were from or their number and both methods had their own degrees of success! In total the night raised €980 and Headway would like to thanks all those who contributed to making it a great success!

Headway’s Carol O’Brien and family enjoying a night at the dog track

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Research Round Up: SelfAwareness After Brain Injury

This edition’s Research Round Up addresses the very complex area of Self-Awareness. Ciara Brien and Cillian McCormack-Doyle guide us through three relevant pieces of research literature.

In everyday life, if we say that someone has low self-awareness, it can be easy to assume that this is somehow their own fault. But with a brain injury, the very mechanisms that allow us to become aware of ourselves and to gain insight into our own situation can be compromised. So, to what extent does having a brain injury impact self-awareness and what difficulty does this pose for people in their recovery? These pieces of research shed some light on the area.

Dirette, D.K. & Plaisier, B.R. (2007) The development of self-awareness of deficits from 1 week to 1 year after traumatic brain injury: Preliminary findings.

Brain Injury. 21 (11), 1131-1136 In the case of brain injury, self-awareness means the ability to accurately recognise the problems caused by the injury. Neural damage after a brain injury can frequently lead to impaired self-awareness. Such deficits in self-awareness can have a negative effect on the achievement of successful rehabilitation. This study aimed to examine the development of selfawareness over time after a traumatic brain injury (TBI). 18 participants who recently experienced a brain injury took part in the research, which involved both the person and their significant other being interviewed 1 week, 1 month, 4 months and 1 year after their injury.

The research found that people with a mild TBI displayed an accurate self-awareness throughout the first year after injury. However people with a moderate to severe TBI tended to overestimate their cognitive abilities until one year after their injury, at which point they rate their cognitive functions similar to the ratings of their significant other.

So, the conclusion was that family members of people with moderate to severe TBI require time to develop their own awareness of the person’s difficulties following brain injury but this awareness develops sooner than the person’s self-awareness.

Fotopoulou, A., Rudd, A., Holmes, P. & Kopelman, M. (2009) Self-observation reinstates motor awareness in anosognosia for hemiplegia. Neuropsychologia.

47 (5), 1256-1260.

Hemiplegia is an inability to move the muscles on one side of the body, and can occur after experiencing a brain injury. Situations can arise when a person suffering from hemiplegia will falsely believe that

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they can move their paralysed limbs. This symptom is termed anosognosia for hemiplegia. Our second article reports a case study which demonstrates the effect of “third person” perspective on a person’s selfawareness of physical limitations.

A 67 year old woman who had suffered a large right sided middle cerebral artery stroke was the subject of this case study. At 22 days after her injury, despite an acknowledgement that her left side was weaker than her right, her lack of awareness of her left upper limb paralysis persisted. She was then shown a 90 second video clip of her answering general questions about her limb functionality and being asked to perform specific actions with her impaired (left-sided) limbs.

This more remote and objective viewing of her own inability to perform the requested tasks resulted in immediate and full self-awareness of her left sided paralysis, with this awareness still intact at a 6 month follow up.

Lundqvist, A., Linnros, H., Orlenius, H. & Samuelsson, K. (2010). Improved self-awareness and coping strategies for patients with acquired brain injury—A group therapy programme. Brain Injury, 24(6), 823832.

Self-awareness has been proposed to consist of intellectual awareness (being able to describe your difficulties), emergent awareness (being able to notice when you are having difficulty) and anticipatory awareness (being able to predict in advance what situations will be difficult). Anticipatory self-awareness seems to be a prerequisite for developing good coping strategies after a brain injury, as people have to be aware of what type of situations they might find difficult, before they can plan for these situations. The authors of our final article sought to determine if a group therapy programme could help individuals with brain injury to develop anticipatory awareness and coping strategies.

The programme focused on learning to recognize in advance when, and in what situations, the individual’s problems were likely to occur. The programme also aimed to provide the participants with a safe environment to talk about themselves, experience peer support, get feedback from one another and practice strategies. The authors ran three therapy groups and assessed the impact of these groups using questionnaires, interviews and focus group discussions.

Making Headway The results showed that a structured group therapy programme can help patients with acquired brain injury to understand the consequences of their neuropsychological difficulties, improve awareness of these and develop and implement coping strategies.

Attending the group also had a positive effect on their life and work situation and on their self-confidence.

If you would like to learn more about Headway’s peer support group, called the Harbour Group, please contact our Information and Support Line on 1890 200 278, or via email at helpline@headway.ie

New Headway Day Rehabilitation Service in Cobh This year, in response to local need, Headway set

up a new day rehabilitation service based in Cobh.

Day Service Officer, Jennifer Cotter writes about the adventure... ‘’All journeys begin with a simple step’’. A new year and a new service in Cobh was an adventure I and my co worker Jean were very much looking forward to embarking on. We are now based in Cobh Parish Centre every Wednesday; the group are a combination of new clients and three clients who have been attending Headway services for a number of years in our Ballincollig centre. One detail bonds the entire group; they are all extremely proud Cobh men. Our days are often filled with interesting stories and facts about the locality and the rich history of the island.

Spring 2012

Research Extra: Congratulations to Michelle Murphy in our Limerick centre on the recent attainment of her Masters Degree in Cognitive & Behavioural Therapy with the Irish College of Humanities and Applied Sciences. Research undertaken by Michelle for her degree explored the experience of counsellors who work with survivors of acquired brain injury and looked at the impact on counsellors of working with this group of people. An article based on her recent research, which may be of interest to counsellors and psychologists working in the field, will be available on the Headway website.

The Community of Cobh have made us feel very welcome. We are so grateful to the Parish Centre and the Community Hospital for all their support for the new service. During Brain Awareness Week, a Boccia Tournament between the hospital and Headway proved to be a great success. It was a close game but in the last round the Headway team were victorious and brought home gold medals! We plan to defend our title in a rematch during the summer months.

Headway Cobh service users enjoying the Boccia Tournament

Thank you! Thank You! Thank You! We want to say a huge big thanks to the following

funds for us in a cycle ride on the other side of the world (Australia); to Malcomson Law for ongoing relationship and support; to Mark Brady of Square Design for help with our annual report; to Glen Power of The Script, Clodagh McKenna and The Davenport Hotel for their support and finally...

Dermot O’Brien from O’Brien printing for their help with our 2012 calendar; St. Belinda’s College and the congregation of St. Brendan’s Church Coolock for their generosity; also to Edel Hyland for raising

to all our supporters, donors, service users and family members.

Your Quality Feedback Counts

we might do things better, differently or even not at all, we will be seeking your feedback. This might be in an anonymous survey or a focus group or a meeting but it could also be through a method which you choose. If you have something you’d like to tell us about how we are doing, please let us know and contact us at email: info@headway.ie, telephone 1890 200 278 or write to me at the address for Cork Psychology & Family Support Services on the back page. All feedback, ideas and suggestions are welcome and will be forwarded to our quality team.

Christine Flynn CARF Coordinator

people:

The quality of the service we provide is really important to us. This year, Headway have started preparation to apply for a quality standard administered by an organisation called CARF (the Commission for Accreditation of Rehabilitation Facilities–www.carf.org).

One way for us to improve our services is to listen hard to the people who count. That’s you! Whether you use our service or whether you have an opinion about how

Thank you!

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Making Headway

Contact Information Head Office Unit 1-3 Manor St. Business Park, Manor St., Dublin 7 Tel: (01) 810 2066 Fax: (01) 810 2070 Web: www.headway.ie Email: info@headway.ie

Information and Support Line

1890 200 278

email: helpline@headway.ie Monday – Friday, 9 am to 1 pm and 2 – 5 pm (local call rate) Dublin Office Unit 1-3 Manor Street Business Pk, Shea’s Lane, off Manor Street, Dublin 7 Tel: 01 810 2066 Fax: 01 810 2070 Web: www.headway.ie Email: info@headway.ie Rehabilitative Training & Day Rehabilitative Services, Employment Support, Community Reintegration, Neuropsychological Assessment, Psychotherapy, Counselling and Information and Support.

Cork Office Unit B3, Link Road Business Park, Ballincollig, Cork Tel: 021 487 1303 Fax: 021 487 1305 Rehabilitative Training & Employment Support, Rehabilitative Day Services and Community Integration.

Cork Psychology & Family Support Services Kenny Group House, Carrigrohane Road, Cork Tel: 021 434 7625 Fax: 021 434 7477 Brain Injury Rehabilitation, Neuropsychological Assessment, Psychotherapy, Counselling, Family Support,and Social Work Services.

Limerick Office Jutland Hall, Steamboat Quay, Dock Rd., Limerick Tel: 061 469 305 or 061 469 306 Rehabilitative Training, Vocational Training Programme, Supported Employment, Neuropsychological Assessment, Psychotherapy,Counselling and Family Support

Spring 2012

Upcoming Events Run for Headway – Following an appeal by Glen Power of the Script we are asking supporters to consider running for Headway in one of the marathon and mini marathon events around the country. See www.headway.ie/runforheadway Monthly Carers Group Dublin – We operate a monthly support group for family members and carers of people with brain injury in our Dublin centre. Check our website for details of the next date Beach Cleanup – as part of Coca Cola Clean Coast Week, on May 11th we are taking part in an educational tour, and beach cleanup of Bull Island.

So if you have a passion for environmental issues, or want to enjoy a sociable morning in the fresh air, then this may be just be the event for you. This event is open to Headway service users. For more information on how to get involved please contact Elisa on odonovane@headway.ie or 086-1072597 Dublin Staff Relay – 24th May Once again, our staff team of intrepid runners will compete in this fun race to be held in the Phoenix Park. All sponsorship is welcome, contact Ciarán on 01 810 2098 Charity 25 Golf Classic and Ball – A golf classic will be held on Tuesday 3rd July at a leading golf venue in Leinster (to be confirmed). The Mrs Brown Charity Ball will take place on Sunday 16th December at a Dublin hotel venue (to be confirmed). Headway benefits from your support – see our website for more details Limerick Golf Classic and Annual Ball – keep an eye on our website for more details For up to date listings, please check www.headway.ie/events

Kerry Office (Psychological Services) Fairies Cross, Clounalour, Tralee, Co. Kerry Tel: 066 711 9320 Fax: 066 711 9321 Psychotherapy and Counselling South East Office 15 Old Dublin Road, Carlow Tel: 059 9134029 Information and Support, Family Support

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