How counselling supports brain injury survivors and their carers

Every 90 seconds, a person in the UK is admitted to a hospital for an acquired brain injury (ABI). That’s over 335,000 admissions per year, according to Headway, the brain injury association. We call this type of brain injury ‘acquired’ because the person was not born with it. ABIs include a range of conditions such as strokes, brain tumours, encephalitis, as well as road traffic collisions and falls.

The effects of acquired brain injuries on survivors

Survivors of ABIs have to deal with various challenges. They may suffer physical disabilities, cognitive difficulties, loss of peripheral vision, headaches, dizziness, balance issues, and nausea, to name but a few. These challenges often come with intense emotional responses: loss of identity, grief (especially grieving their previous life), confusion, frustration and anger, and sometimes confabulation (when the person has false or distorted memories without the intention to deceive), and many more.

Trauma is often a complication of an ABI, too. The accident that caused the head injury or hearing the news of the medical condition can generate symptoms of PTSD (post-traumatic stress disorder), even in cases of mild traumatic brain injuries. All of these affect the well-being of survivors of ABIs greatly.

Supporting carers through counselling

An acquired brain injury not only has a profound effect on the life of the survivor, but also the people around them: their carer(s), their family, and friends. Carers of ABI survivors may benefit from specialised support from a counsellor who understands brain injuries and the challenges they present for both the survivor and their carer. Sometimes, the personality of their loved ones has changed following the brain injury – the survivor of an ABI may have reduced empathy or increased irritability because some of the cognitive functions have been impaired.

Carers do their best, which can easily lead to burnout, feelings of guilt, role confusion (are they a parent/partner or a carer?) and feeling isolated – as caring is often a 24/7 job, they miss out on their much-needed social life and self-care more generally. In this context, counselling can help carers by helping them set healthier boundaries, regulate their emotions and validate their experience as carers.

In my experience of working with carers of ABI survivors, the feelings of guilt, frustration, and anger can be overwhelming. Counselling can offer a supportive, non-judgemental space where they can process these unwanted feelings and give vent to the pressures they create.

Choosing the most suitable counselling approach for you

In the context of acquired brain injuries, counselling offers a safe, non-judgemental space where a survivor of the brain injury or a carer can explore and process emotions, regain a sense of identity and work towards self-acceptance of their ‘new normal’. In both situations, choosing the right counselling approach may make a difference to your experience of counselling as well as the outcome of the counselling sessions.

Usually, humanistic approaches, such as person-centred counselling (where the pace and content of the session are guided by the client), seem more suitable. But no other approaches should be excluded, as each person is unique and comes with different needs. For clients who have experienced intense trauma, a trauma-informed approach is particularly relevant to meet their therapeutic needs.

In any case, it is essential that the counsellor goes at the pace of the client. A specific approach that finds its origins in the person-centred current and which can be particularly appropriate across the board, is the pluralistic approach. It is based on the idea that no single therapeutic method works for everyone. Instead, it integrates techniques from various modalities, e.g. cognitive behavioural therapy (CBT), psychodynamic, humanistic, acceptance and commitment therapy (ACT), and transactional analysis, among others. A pluralistic counsellor identifies approaches that resonate with the client’s preferences, their personal circumstances, and therapeutic goals.

Counselling in the context of ABI: Empowering growth and resilience

Whether you are the survivor of an ABI or their carer, counselling can help you foster emotional resilience, rebuild your identity and live a more satisfying life. However, sometimes finance can be a significant challenge to accessing specialist counselling.

In this case, you can self-refer to several charities that offer free or low-cost counselling in the UK. The best-known are Headway (the brain injury association), The Brain Charity, and DisabilityPlus. These charities usually provide a minimum of six counselling sessions that can sometimes be extended. 

In addition, some counsellors offer a sliding scale for those with financial constraints. Check their website to find out if they offer a number of reduced-fee sessions or ask a therapist directly. Many of us counsellors and psychotherapists aim to make therapy more accessible and inclusive. Living with or caring for someone with an acquired brain injury is challenging – support is available, so please don’t hesitate to seek help.