Holding Resilience in Trust: Working Systemically With Families Following an Acquired Brain Injury

ABSTRACT

The conceptualization of resilience following acquired brain injury needs to remain sensitive to the complex nature and enduring dimensions of trauma, loss, and stress. It is essential that a systemic and dynamic view be maintained with a focus on the key adaptation tasks that families face: grieving, restructuring, identity redefinition, and growing through adversity. These tasks are explored in a case example illustrating how these challenges reemerge across the life cycle. The key theme in this contribution is that resilience is a fluid property, a potential that practitioners and service systems can listen for, support, strengthen, and hold in trust.

KEYWORDS:

• Brain injury
• disability models
• evidence-based practice
• family resilience
• family therapy
• people with disabilities
• social work practice and disabilities
• strength-based perspective

Acknowledgments

Our thanks to the Morris family for their permission to draw on their experience in this article. We would also like to thank Dr. Mark Furlong, Thinker in Residence, Adjunct Senior Lecturer, The Bouverie Centre, for his assistance in preparing this material.

Notes on contributors

Franca Butera-Prinzi, BA, BSW, GraDipFamTher, MFamTher, is a social worker and family therapist with 30 years of experience as a clinician, trainer, supervisor, manager, and consultant in a variety of settings including acute, rehabilitation, community health, and child welfare. She has extensive experience working with children, adolescents, adults, and couples who have been affected by grief, trauma, and disability, including mental health and acquired brain injury. Strength-based practice is fundamental to her work in providing positive outcomes. She is currently the Team Leader of the Acquired Brain Injury team at The Bouverie Centre and Acting Clinical Program Manager.

Nella Charles, BBSc (Psych), GradDipEdPsych, GradDipFAmTher, MClinPsych, is a family therapist and psychologist at The Bouverie Centre, where she is employed on a part-time basis as a clinician and teacher in family therapy. She has a breadth of experience in family work, with particular experience in disability and child welfare. She has worked with families affected by acquired brain injury for more than 18 years and provides training and consultation to the brain injury field. She has a particular interest in the treatment of trauma and use of creative methods in group work.

Karen Story, BA, Dip Soc Stud., Dip Ed, MCPP, MCFT, is a social worker, child and adolescent psychotherapist, and family therapist with over 35 years of experience as a clinician, trainer, supervisor, and consultant in a variety of settings, including Child and Adolescent Mental Health Service (CAMHS Austin Health) and Child and Adolescent Schools and Early Action (CASEA) programs; foster care and Department of Human Services; health and welfare community agencies; school and preschools; and university settings. She has extensive experience working with individuals and families as a senior psychotherapist and clinical mental health social worker at Austin CAMHS and in private practice with families, adolescents, children, adults, and couples, as well as group work. She is coauthor and trainer of the Exploring Together multigroup program and a trainer for Tuning Into Kids (TIK) and Tuning into Teens (TinT) programs. She is currently a family therapist on the Acquired Brain Injury team.

Notes

Unlike the death of a loved one where there is a clear loss and mourning, with ambiguous loss there is no closure as the person may be alive but psychologically or cognitively unavailable as in dementia or acquired brain injury.