Mindful Connections: The Role of a Peer Support Group on the Psychosocial Adjustment for Adults Recovering From Brain Injury

ABSTRACT

How does participating in a peer support group impact an adult’s psychosocial adjustment following brain injury? This question was investigated using a qualitative approach, interviewing patients recruited from an ambulatory care program. Data analysis guided by Bury’s sociological framework, biographical disruption and biographical repair, revealed participants’ pregroup disrupted sense of self, including subthemes related to intrinsic losses and uncertainty. Enhanced psychosocial adjustment including subthemes described participants’ reorientation through shared experience. Finally, a postgroup adapted sense of self including subthemes was characterized by heightened purpose, self-awareness, and acceptance. Findings lend weight to using tailored peer interventions to optimize psychosocial adjustment for this population.

KEYWORDS:

• Acquired brain injury
• disability frameworks
• mental health recovery
• neurorehabilitation
• peer group
• psychosocial
• qualitative
• stroke

Acknowledgments

The authors would like to thank Sylvia Hoang, Mary McAllister, and Jennifer Spencer for their earlier contributions to this study. We would also like to thank the 16 participants for volunteering their time and sharing their experiences with brain injury.

Notes on contributors

Melissa Cutler, MSW, RSW, is a clinical social worker who has specialized in the field of neurorehabilitation and mental health for 15 years. She works within the Ambulatory Care Program at Sinai Health System–Bridgepoint Site in Toronto, Canada where she provides individual, couples, and group counseling for people living with stroke, brain injury, and postconcussion syndrome. She received master’s degrees in both psychology and social work from the University of Toronto, where she was the recipient of an Excellence in Field Education Award from the Factor-Inwentash Faculty of Social Work. Melissa holds specific training in cognitive-behavioral therapy (CBT), trauma counseling, and chronic pain management. Her teaching and clinical interests include examining the life adjustment for young adult survivors of neurological events.

Michelle L. A. Nelson, PhD, is a Research Scientist at the Bridgepoint Collaboratory, Lunenfeld-Tanenbaum Research Institute. She has academic appointments in the Daphne Cockwell School of Nursing at Ryerson University and the Dalla Lana School of Public Health, Division of Clinical Public Health, at the University of Toronto. Her program of research focuses on complex inpatient neurorehabilitation and community reintegration.

Maya Nikoloski, RN, MN, currently works as the Manager of Professional Practice Nursing at Bridgepoint Hospital, Sinai Health System. She has a master’s of nursing degree from Ryerson University, and has a certificate in gerontological nursing from the Canadian Nurses Association. She has a keen interest in patient safety and is a certified Patient Safety Trainer with the Canadian Patient Safety Institute. She continues to be actively engaged in professional development and academia through her Adjunct Lecturer appointment with the Lawrence S. Bloomberg Faculty of Nursing, University of Toronto.

Kerry Kuluski, MSW, PhD, is a scientist at the Lunenfeld-Tanenbaum Research Institute, Sinai Health System, and Assistant Professor at the Institute of Health Policy, Management, and Evaluation, Dalla Lana School of Public Health, University of Toronto. She is an applied health services researcher and a social worker by training. She received her MSW from Lakehead University and a PhD in health services and policy research from the University of Toronto. Following her PhD, she had a Postdoctoral Visiting Fellowship at the University of Oxford. She is the recipient of several extracurricular leadership awards and a Literary Award in Health Services Evaluation. She is also co-investigator on over $7.5 million in externally funded research. Her current research focuses on health system performance through the eyes of patients and their caregivers. In her research she draws on the patient and caregiver experience to explore and inform ways in which home and community care can be optimized to offset premature long-term care and hospital use.