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What is the meaning of recovery as lived by persons with traumatic brain injury? Lewington, Philippa J.

Abstract

To understand the meaning of recovery from traumatic brain injury (TBI) this study sought the perspective of persons living the experience. Each participant was engaged as a co-researcher to make sense of this complex phenomenon. A multiple case study approach was used and seven adults volunteered to share their stories over two interviews. The study produced seven narrative accounts which were the joint product of focused conversation and an explicit, mutual goal. To address the influence of the interviewer, narratives were examined and validated by the participants and by an independent reviewer to ensure they were accurate and complete. Themes emerged through detailed and rigorous analysis of the interviews and narrative accounts. Adherence to protocol, reviews and consultation assured valid results. Themes were compared across accounts and a cyclical and dynamic pattern took form. It incorporated themes of trauma, deconstruction of a previous life story, reconstruction of a new life story and recovery. These themes were interwoven across four streams of life. One was an internal, deeply personal and emotional experience. Another involved external reactions to the events around the person. An interpersonal stream addressed relationships and an intrapersonal stream referred to sense of identity. The results of this study challenge structured stage models described in rehabilitation and brain injury literature. Rather than following clearly-defined steps, the co-researchers described turbulent spirals of trauma, destruction and renewal. Popular theory expounds acceptance and adjustment as a final stage in recovery. The results of this study suggested that the battle to attain such resolution is fought earlier in the story of recovery. Practical implications apply to treatment program design and to individual and group counselling with persons with TBI. The role of the counsellor is crucial to creating a more conjoint approach to treatment. Events which serve to deconstruct and/or reconstruct life stories can be understood collaboratively and constructively in the counselling relationship. The individuals in this study valued empathy, validation, comprehension and control within a treatment plan which maximized recovery potential by assisting them in defining and attaining personal, social and vocational goals.

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