Resiliency in the Context of Traumatic Brain Injury: Conceptual Understandings and Implications for Rehabilitation

Presenters:

  • Gillian King
  • Anne Hunt
  • Deirdre Dawson
  • Emily Nalder

Objectives:

  • Describe the construct of resiliency, and the rationale for studying this in relation to TBI
  • Discuss different ways that resiliency is conceptualized in the literature, and be familiar with two specific conceptual models of resiliency that are applicable to rehabilitation
  • Identify positive life outcomes that may be indicative of resiliency following TBI

Description:

Evidence shows that traumatic brain injury (TBI) presents a multifaceted adversity requiring individuals to reconstruct their sense of self [1] and change their beliefs about what gives meaning to their life [2]. However, we know little about how these changes occur, or how they are fostered by rehabilitative or social supports. Resiliency refers to positive adaptation to life’s challenges [3]. This symposium will discuss current evidence examining resiliency in the context of TBI.

The first talk of this symposium will introduce the construct of resiliency and why it is relevant to study in the context of TBI. The two defining features of resiliency are that it occurs in response to adversity, and that it involves positive adaptation. [3] Adversity refers to significant life challenges and can be situational (e.g., a life event such as TBI) or more chronic (e.g., prolonged exposure to stressors such as poverty). Positive adaptation refers to how individuals reduce the potential negative impacts of adversity and achieve positive life outcomes. [3,4] Resiliency can explain the processes through which individuals with TBI utilize personal strengths and harness supports, to manage adversity and achieve success in life.

The second presentation will discuss different conceptual understandings of resiliency in the literature. Two recently published conceptual models will be described, a traumatic brain injury resiliency model, [4] and a transactional resiliency framework for rehabilitation. [5] The first, is an overall process-oriented resiliency model for the TBI context that stresses self-regulatory processes. The latter model focuses on adaptive self-capacities implicated in resiliency, including self-efficacy, the capacity to marshal or create resources and supports, life situation adaptability, and envisioning a positive future. Adaptive self-capacities are a novel construct that can guide measurement and intervention.

The third presentation will further explore what “success in life” means to individuals with TBI. The results from a scoping review will be presented, characterizing the positive life outcomes that may be indicative of resiliency following TBI. These outcomes relate to subjective experiences (e.g., wellbeing, satisfaction), different life domains (e.g., work, social integration), sense of self, and to adaptation or adjustment processes (e.g., reconstruction / re-integration).

The fourth presentation will present a method for studying resiliency. Body mapping is an arts-based method of drawing and painting an embodied visual narrative to express one’s experiences. [6] As applied to resiliency in TBI, body mapping produces a life-sized picture by asking individuals about life following TBI, turning points that they experienced, and how they have built resiliency. Data will be presented from related ABI-based body-mapping studies to demonstrate the promise of the methodology.

The symposium will conclude with a discussion of the implications for rehabilitation. A discussant will pose key questions to illuminate areas for further study, and opportunities to apply a resiliency framework to inform rehabilitation practice.

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