A qualitative exploration into the processes in which occupational therapists engage when training a client to use external memory aids after a traumatic brain injury
Armstrong, Jonathan David
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Occupational Therapists working in neurological rehabilitation frequently receive referrals to assist people with memory impairments following traumatic brain injury (TBI). Although there are a number of options available for the rehabilitation of memory, the evidence to date suggests that the use of external memory aids is one of the best approaches to take with these individuals. Unfortunately, there is very little evidence to guide therapists in training clients with TBI to use an external memory aid and ensure sustainable use of the aid long-term. Using grounded theory methodology occupational therapists working in the field of neurological rehabilitation were interviewed to explore the question: How do occupational therapists train clients to use external memory aids after a TBI? Eight interviews were conducted until data collection reached a saturation point. The data was analysed following the constant comparative method proposed by Strauss and Corbin (1998) and from this analysis four over-lapping processes emerged: Developing client insight, getting client buy-in, getting others on-board and making it real Developing client insight was the process that the occupational therapists went through in order to build their clients’ awareness of their memory impairments and the impact these impairments had on their everyday activities. This was felt to be an important first step in engaging a client in the use of a memory aid. Getting client buy-in involved the occupational therapists finding ways to engage their clients in the training and making it meaningful to them. Getting others on-board was a process of recruiting people like family members, rehabilitation staff and employers into the training as a way to ensure repetition of training components and maintaining the use of the aid when the client was not engaged in formal therapy sessions. Making it real emerged as the core process that encompassed and ran through the other three. It emphasized the need for the occupational therapists to use meaningful, functional activities in order to establish an aid that fit the client’s real life. The processes uncovered by this study address a number of barriers to external memory aid training that have been highlighted in the literature and give occupational therapists working in the field of brain injury rehabilitation some guidance for clinical practice.