Research Proposal
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TRAUMATIC BRAIN INJURY: HANDBOOK FOR COUNSELORS AND RESOURCE DIRECTORY FOR CALIFORNIA AGENCIES A Project Presented to the faculty of the Graduate and Professional Studies in Education California State University, Sacramento Submitted in partial satisfaction of the requirements for the degree of MASTER OF SCIENCE in Counseling (Vocational Rehabilitation) by Shanna Welch SPRING 2014 © 2014 Shanna Welch ALL RIGHTS RESERVED ii TRAUMATIC BRAIN INJURY: HANDBOOK FOR COUNSELORS AND RESOURCE DIRECTORY FOR CALIFORNIA AGENCIES A Project by Shanna Welch Approved by: __________________________________, Committee Chair Guy Deaner, Ph.D. Date iii Student: Shanna Welch I certify that this student has met the requirements for format contained in the University format manual, and that this project is suitable for shelving in the Library and credit is to be awarded for the project. , Department Chair Susan Heredia, Ph.D. Date Graduate and Professional Studies in Education iv Abstract of TRAUMATIC BRAIN INJURY: HANDBOOK FOR COUNSELORS AND RESOURCE DIRECTORY FOR CALIFORNIA AGENCIES by Shanna Welch Statement of the Problem The purpose of this project was to develop a handbook for professionals who work with people who have a Traumatic Brain Injury (TBI) and their families as well as develop a comprehensive, California resource directory. The last time this sort of project was done was in 2004, so a newer and updated version was clearly needed. The handbook will serve to educate professionals regarding the unique conditions and challenges of clients who have TBI as well as methods to help that individual get to work. The community resource directory will serve as a repository of information for professionals while providing assistance to individuals with TBI and their families. Sources of Data Sources of data for the development of this project included a review of related literature in vocational rehabilitation counseling; traumatic and acquired brain injury literature; journal articles, books, and internet sites detailing research and studies related to TBI; and unpublished masters projects and theses. Information was updated and assessed for relevance from Kristen Kunz's 2004 thesis, Traumatic Brain Injury: A v Handbook and Comprehensive Sacramento Area Community Resource Directory. Also consulted were California and national organizations deemed relevant by this author to be listed in the directory. The Traumatic Brain Injury Resource Directory (TBIRD): A Guide to Northern California Resources for Individuals with Brain Injury, 6th edition (2006); the Brain Injury Association of California Resources (2014); and the Community Services Directory, 57th edition (City of Sacramento, 2011) were reviewed. Conclusions Reached TBI is so complex that one specialty cannot fulfill the counseling needs for these clients. A handbook was developed to educate professionals regarding the unique conditions and challenges of clients who have a TBI, and a California resource directory was developed to serve as a repository of information for professionals and to provide assistance to individuals with TBI and their families. , Committee Chair Guy Deaner, Ph.D. Date vi ACKNOWLEDGMENTS Production of this handbook and directory was accomplished under the direction of Lynda Eaton of Mercy Hospital Outpatient Rehab Center and the Head Trauma Support Project, Inc.; Eric J. Ratinoff and Taryn J. Smith of Kershaw, Cutter, & Ratinoff, LLP; and Guy Deaner, advisor to Shanna Welch, and Professor at California State University, Sacramento. Special thanks go to each of them for their encouragement, direction, and support. Special thanks also goes to Tami Welch, mother of Shanna Welch, for all of the hours she spent helping type up resources for the directory and for checking the websites to ensure all the information was current and updated. The printing and production of this directory is provided by Eric J. Ratinoff, Civil Justice Attorney, and this assistance is very gratefully acknowledged. vii TABLE OF CONTENTS Page Acknowledgments............................................................................................................. vii Chapter 1. INTRODUCTION .........................................................................................................1 Background of the Problem .....................................................................................1 Statement of the Problem .........................................................................................6 Definition of Terms..................................................................................................7 Limitations of the Project.......................................................................................13 Organization of the Project ....................................................................................14 2. REVIEW OF THE LITERATURE .............................................................................15 Introduction ............................................................................................................15 Experiences of Care by Clients and Families ........................................................16 Access to Services..................................................................................................17 Outcome Results from Longitudinal Studies .........................................................25 Improvements in Services ......................................................................................31 Factors Leading to Successful Vocational Outcomes ............................................34 Summary ................................................................................................................44 3. METHODOLOGY ......................................................................................................47 4. SUMMARY AND RECOMMENDATIONS..............................................................52 Summary ................................................................................................................52 viii Recommendations ..................................................................................................53 Appendix A. Traumatic Brain Injury: A Handbook for Counselors .................................56 Appendix B. Traumatic Brain Injury: A Comprehensive California Resource Directory .....................................................................................................101 References ........................................................................................................................244 ix 1 Chapter 1 INTRODUCTION Background of the Problem The author became acquainted with Traumatic Brain Injury (TBI) in 2011 when she started graduate school. The author had studied psychology in the past and was always fascinated by the brain and even more intrigued when hearing about TBI in her “Medical Aspects” class. She studied TBI thoroughly including limitations and vocational outcomes, and to this day she continues to learn. The author volunteers with people with TBI at Mercy Outpatient Rehabilitation Center and helped plan the “Walk For Brain Injury” in the past. This passion for those with brain injury is what started her interest in this project. According to Kolakowsky-Hayner (2010), TBI is a global health problem and one of the leading causes of death and disability in the United States, especially among persons under the age of 50. On average, the greatest number of TBIs occur in persons between the ages of 16-35 (Kolakowsky-Hayner, 2010). In the United States, someone receives a TBI every 23 seconds. Over one and a half million injuries occur per year, with 290,000 severe enough for hospitalization, eight times the number of people diagnosed with breast cancer and 34 times the number of new cases of HIV and AIDS each year (Kolakowsky-Hayner, 2010). Persons with brain injury often experience many different lasting functional problems. Although some problems are resolved relatively early post-injury, deficits have been known to persist for nearly a decade or more 2 (Kolakowsky-Hayner, 2010). Due to such an extended recovery period, finding and maintaining employment are ongoing problems for persons with brain injury. Research suggests that returning to work after brain injury is limited to as little as one-third of the brain-injured population (Kolakowsky-Hayner, 2010). Brain injury is not something that should be ignored. Access to services and treatment for people with brain injury (BI) is very important to have but not always easy to come by. A study by O’Callaghan, McAlister, and Wilson (2010) indicated very few participants reported receiving services in line with recommendations made in clinical care guidelines. All the adults with TBI reported accessing acute care. However, their access to care following this point dropped. Sixty-four percent of participants with TBI reported receiving inpatient rehabilitation services. Participation increased slightly to 70% receiving outpatient rehabilitation, but only 25% of the participants with TBI stated they were receiving therapy services at the time of the study and only 22% reported they received ongoing monitoring. Over half the participants with TBI reported neither receiving therapy nor ongoing monitoring at the time of the study (O’Callaghan et al., 2010). In a different study, Leith, Phillips, and Sample’s (2004) objective was to learn what the individuals in four focus groups (with persons with TBI and their families) in South