Friend or foe: the media’s power to inform and shape societal attitudes towards people with acquired brain injury

Media representations play an integral role in modern society, informing the public about a range of issues affecting their communities. Using qualitative content analysis, this article reports on the study of a sample of Australian media coverage, spanning 30 years, covering issues associated with acquired brain injury (ABI) and related cognitive disabilities. The analysis explores how the media both portray and actively shape public perceptions about people living with ABI, the lived experience of the condition, and its broader social implications. The authors identify a range of themes arising in the sample that communicate specific ideas about ABI, disability, and deviance. Importantly, they identify how these themes are able to either construct or reinforce dominant understandings of disability and deviance through both their content and structure.     

The use of photovoice with people with intellectual disabilities: reflections,challenges and opportunities

Photovoice is part of the growing use of participatory research approaches with people with intellectual disabilities. In this paper we explore the process, opportunities and challenges associated with the use of photovoice with people with intellectual disabilities, illustrated through a research project entitled ‘This Is Me’. Photovoice requires researchers to share power and control in the research process and to tolerate uncertainty. Large investments in time and money are also required. These challenges, however, are outweighed by the benefits of the use of photovoice with people with intellectual disabilities. Photovoice creates a space where people with intellectual disabilities can meaningfully participate and exert control in the research process, and as such is an empowering experience. As a participatory research approach, photovoice is accessible and offers the opportunity for people with intellectual disabilities to develop new skills, confidence and experience inclusiveness in their own terms.     

Men, sport, and spinal cord injury: an analysis of metaphors and narrative types

This article draws upon life history data from a small group of men who have experienced spinal cord injury (SCI) through playing the sport of rugby union football and now define themselves as disabled. The salient and most common metaphors used by the men in telling their stories post SCI, and the manner in which this is shaped by three narrative types, is focused upon in detail. The implications of this dynamic process for their identity reconstruction as disabled men are considered.     

Dealing with the 'Void': traumatic brain injury as a story

Traumatic brain injury (TBI) is considered to drastically affect the individual's sense of self. To discover how people with TBI understand themselves, in-depth interviews with four individuals with TBI were conducted. Their narratives suggest that they feel they are carrying a 'void' in their understandings of their past and present. Individuals tend to fill the 'void' in their long-term memory with stories about the accident and recovery. The concept of 'void' is also useful in understanding how TBI survivors view the causal relationship between the accident, the brain injury and their present difficulties. This relationship can be another 'void' that threatens their sense of agency. The findings suggest that the experience of TBI appears as meanings in their self-narratives rather than as objective truth. Rehabilitation professionals should consider how their client interprets his or her TBI and self in everyday life when they work with this population.     

Homelessness and Mental Disorder: Policy Considerations

Abstract

‘Photovoice’ is a photographic method that is used for several purposes (e.g. storytelling, building awareness, enhancing personal discovery), including conducting community-based participatory research (CBPR). Since its creation, photovoice has been used as a method for implementing health-related CBPR projects with people experiencing homelessness. As such, this article presents an overview of seven peer-reviewed publications regarding photovoice projects that were conducted with participants who are homeless. The goal of the review is to provide health professionals with a practical summary of the lessons learned from each photovoice project's methods and findings. Based on the literature, the review's major suggestion is that health professionals should plan and implement future projects according to the fundamental aspects of photovoice (e.g. empowerment of participants to document their community, facilitation of group discussions of photos, concerted efforts to reach policymakers).     

The art of resilience: photo-stories of inspiration and strength among people with HIV/AIDS

Using the visual arts to aid healing is a common therapy for people with critical illness, yet the use of art to improve the lives of people with HIV is under-utilised. Eight male and 20 female participants living with HIV in urban areas of the Midwest, United States, participated in three group photovoice photo-sharing and discussion sessions, post-project individual interviews and a community photo exhibit. We used a grounded theory approach to analyse interview data and identified three key themes: (1) health and wellness, (2) fear and stigma and (3) restoring a threatened identity. Participants identified how taking photos, reflecting on and sharing them in focus groups helped them express themselves while living with and coping with HIV. Offering photography as form of expression is a way to foster strength and, consequently, improve the lives of people living with HIV. Our participants benefitted from the process of telling their story with images. They were able to express positive aspects of their lives which could be a healthy form of catharsis in and of itself. Future research should continue to investigate how participants in participatory approaches like photovoice actually do benefit from the research. Although we focused this analysis on resilience, photovoice is flexible and participants’ responses to it are varied. Additional outcomes such as impact on mental and physical health are worthy of additional exploration.     

Work-related mild-moderate traumatic brain injury and the construction industry

Background: Consequences of traumatic brain injury underscore the need to study high-risk groups. Few studies have investigated work-related traumatic brain injuries (WrTBIs) in the construction industry. Objective: To examine WrTBIs in Ontario for the construction industry compared to other industries. Methods: A retrospective study of individuals who sustained a WrTBI and had a clinical assessment as an outpatient at a hospital-based referral centre. Data were collected for a number of factors including demographic, injury and occupation and were analyzed according to the Person-Environment-Occupation (PEO) model. Participants: 435 individuals who sustained a WrTBI. Results: There were 19.1% in the construction industry, 80.9% in other industries. Compared to other industries, individuals in the construction industry were more likely to be male, to not have attained post-secondary education, and experience multiple traumas. WrTBIs in the construction industry were commonly due to elevated work. The construction occupations involved included skilled workers and general labourers, and compared to other industries, WrTBIs occurred most often for those employed for a short duration in the construction industry.Conclusions: Construction industry workers experience serious WrTBIs that are amenable to prevention. Use of the PEO model increased our understanding of WrTBIs in the construction industry.     

Giving hope in brain injury. An exploration of families' experiences with the brainwave organisation and therapy

This exploratory study examined families' experiences during the care of brain‐injured children being treated with therapy from the Brainwave organisation. Families highlighted areas of dissatisfaction with existing services. The friendly and positive attitudes they received from Brainwave staff were an indication of hope for the future. Involvement in their children's care and being valued during decision making were advantages attributed to the Brainwave organisation. The study has produced recommendations for the Brainwave Centre to improve their service delivery as well as important areas within conventional care that could be improved and developed to help families with brain injury. Copyright © 2002 John Wiley & Sons, Ltd.     

Prediction of vocational outcome of people with brain injury after rehabilitation: a discriminant analysis

Due to advancements in emergency evacuation procedures and neurosurgical techniques, more patients with brain injury (BI) can survive cerebral injury and regain a satisfactory degree of recovery through rehabilitation. Their improvement in physical and cognitive functions can facilitate their reintegration into the community, especially their return to work (RTW). Different factors were reported to affect this rate of RTW in previous studies. This retrospective study thus aimed to investigate the role of demographic data, the severity of injury, residual physical deficits, activities of daily living, and cognitive function using a stepwise discriminant function analysis (DFA). Data sets for 79 persons with BI were retrieved so as to identify predictors of their vocational outcomes upon discharge and during a follow-up period. The stepwise DFA revealed that the discharge score on the Disability Rating Scale (DRS), the attention-subtest of the Neurobehavioral Cognitive Status Examination (NCSE) or Cognistat, and pre-morbid occupation were significant predictors that correctly classified 65.8% of the subjects.     

The tidal model. The healing potential of metaphor within a patient's narrative

1. The human experience of growth and development is a fluid phenomenon, occurring in small, barely visible changes. 2. The Tidal Model embraces a patient's expression of his or her experience by focusing on the lived experience of the narrative and its personally meaningful metaphors and symbols. 3. To re-empower a patient, the Tidal Model assessment is written in the patient's own voice and all care planning is conducted conjointly. 4. The Tidal Model was developed from empirical studies of the perceived need for nursing and the process of empowerment in clinical nursing practice.     

Recognition of Nonverbal Communication of Affect Following Traumatic Brain Injury

Recognition of facial expressions and vocal prosody was examined using the Diagnostic Assessment of Nonverbal Accuracy 2 (DANVA-2) and the Carolina Older Adult Test of Nonverbal Communication (COAT-NC) for 24 individuals with traumatic brain injury (TBI) and 24 matched controls. Results demonstrated that participants without TBI scored significantly higher than participants with TBI when presented with adult photo and voice stimuli. No significant group difference was noted with child photo and voice stimuli. Both groups scored significantly higher on photo subtests than on voice subtests for child and younger adult stimuli. For older adult stimuli, both groups scored significantly higher on the voice subtest than on the photo subtest. For the subjects with TBI, a significant relationship was found between scores on the voice subtests and a functional measure of cognition and communication.     

Workplace discrimination and traumatic brain injury: the national EEOC ADA research project

Using the Integrated Mission System of the Equal Employment Opportunity Commission, the employment discrimination experience of Americans with traumatic brain injury is documented. Researchers compare and contrast the key dimensions of workplace discrimination involving Americans with traumatic brain injury and persons with other physical, sensory, and neurological impairments. Specifically, the researchers examine demographic characteristics of the charging parties; the industry designation, location, and size of employers against whom complaints are filed; the nature of discrimination (i.e., type of adverse action) alleged to occur; and the outcome or resolution of the investigations. Findings indicate that persons with traumatic brain injury were more likely to encounter discrimination after obtaining employment as opposed to during the hiring process. They were also more likely to encounter discrimination when they were younger or Caucasian or when employed in the Midwestern or Western United States. Implications are addressed.     

A scoping study of moral injury: Identifying directions for social work research

This paper presents a scoping study of moral injury that identified directions for social work research. “Moral injury” refers to lasting psychological, spiritual and social harm caused by one's own or others' actions in a high stakes situation that transgress deeply held moral beliefs and expectations. A “scoping study” is a type of systematic review and knowledge synthesis useful when considering complex, emerging areas of research. Results revealed an increasing interest in moral injury over the past five years primarily in psychology/psychiatry. The majority of published articles are conceptual. Empirical studies aim to better understand the experience of moral injury, qualitatively; and develop and evaluate instruments to assess moral injury, quantitatively. Most empirical studies of moral injury involve US war veterans with little attention to moral injury in other groups, sociocultural contexts, or at different times in development. Failure to address issues of moral injury in social work may leave vulnerable clients struggling with issues of guilt, shame, moral confusion, and an absence of meaning that may persist for years and create obstacles to positive change. In addition, social workers may experience moral injury as they witness morally injurious behavior of others and of systems. If unaddressed, such injuries may diminish effectiveness, or lead to burn out. Social workers need relevant research to understand the extent to which moral injury affects them and their clients, and how to identify and address it.     

“Basically,I look at it like combat”: Reflections on moral injury by parents involved with child protection services

This study considers any “moral injury” occurring among parents involved with the Child Protection System (CPS). Moral injury refers to the lasting psychological, spiritual and social harm caused by one's own or another's actions in a high stakes situation that transgress deeply held moral beliefs and expectations. The existing literature focuses on military contexts, but moral injury also may play a role in increasing the vulnerability of CPS clients who are threatened with loss of their parental rights and dissolution of their families. We administered a modified version of the Moral Injury Events Scale (MIES) (Nash et al., 2013) to 10 CPS involved parents. We then conducted in-depth, semi-structured, audio recorded individual interviews with parents to elaborate their responses to the MIES. Parents' MIES scores and interview elaborations suggest that some CPS-involved parents do experience moral injury. Moral injury was reported as a result of their own parenting behaviors, but also as a result of parents' involvement with professionals and within social systems that are charged with providing assistance to struggling families. For instance, some parents perceived professionals to be shaming, social services to be harmful and legal proceedings stigmatizing. Parents' reported reactions to morally injurious events included lasting feelings of guilt, shame and anger; and loss of trust in professionals. These responses impeded their perceived abilities to fully engage in services. If involvement in CPS places parents at increased risk of moral injury, then moral injury is a critically important construct for child welfare policy makers and workers to understand and address in the conduct of effective, ethical child welfare practice.     

Using Photovoice as a method to examine microaggressions: Conceptualizing culturally competent practice and curriculum with Asian Americans

ABSTRACT

In recent years, the racial microaggressions has increased significantly in the social work education and negative impact of racial microaggressions on individual’s family and group in their community well-being. Microaggressions can occur out of misunderstanding and lack of awareness of cultural differences and similarities. Microaggressions also are common everyday whether intentional or unintentional. The purpose of this study is to examine the evolving methodology, usage of photovoice, and conceptualizing culturally competent practice and curriculum with Asian Americans.     

Projective Identification: A Request for Relationship

Projective identification is commonly recognized as a primitive defense. In group work with ego-impaired preadolescent boys with significant environmental deficits, projective identification is used to communicate a need for a relationship previously unavailable to them. These boys project unwanted aspects of themselves in order to have them contained by the therapist. They induce feelings in the therapist in order to share their internal experience. As the feelings are modified by the therapist and reintrojected by the boys, the boys receive the parenting they missed and are able to form more stable attachments.     

Fostering democracy through social media: Evaluating diametrically opposed nonprofit advocacy organizations’ use of Facebook,Twitter, and YouTube

Nonprofit organizations contribute to a democratic society by allowing those with diverse opinions to assemble and voice these ideas. Social media has provided an extensive new marketplace in which such organizations can give voice to their ideas. Thus the purpose of this study was to explore and assess the use of social media (Facebook, Twitter, and YouTube) for advocacy by nonprofit organizations with diametrically opposed points-of-view on two social issues, the pro-gun/gun control issue and the pro-choice/pro-life issue. Results of this study indicate that nonprofit advocacy organizations are using social media to ethically persuade people to their point of view, for the most part through use of one-way communication. Moreover, organizations are using the various social media for different purposes, providing thanks and recognition on Twitter, and soliciting feedback and other two-way communication with stakeholders on Facebook. Use of authority figures to communicate messages is generally reserved for YouTube.