HCPC registered psychologists with expertise and experience in neurorehabilitation. We offer services such as neuropsychological assessment NPsych

#NPsychPick of the Month: Applying EMDR therapy with clients who have impaired cognitive abilities, EMDR Therapy Quarterly, Summer 2023

Neuro EMDR: Applying EMDR therapy with clients who have impaired cognitive abilities

Author: Dr Jonathan Hutchins Simon Proudlock

EMDR therapy has been shown to be highly effective and time efficient in addressing trauma memories in both adults and children. However, there are questions about how EMDR can be effective with adults who have experienced a brain injury or are experiencing other cognitive difficulties. This article summarises some of the recent research within the area and proposes adaptations to the standard protocol that can be made to make best use of EMDR therapy in this population.

Introduction

Within the UK in 2019-2020 there were 356,669 UK admissions to hospital with acquired brain injury (ABI), or any brain injury that has occurred after birth including traumatic brain injury (TBI), stroke or brain tumours, which is a 12% increase since 2005-2006 (Headway, 2023). In 2019, there were approximately 977 TBI admissions per day to UK hospitals, one every 90 seconds. The diagnostic criteria for TBI on the DSM V states that there must be an “impact to the head or other mechanisms of rapid movement or displacement of the brain within the skull with one or more of the following: loss of consciousness, posttraumatic amnesia, disorientation and confusion, neurological signs such as neuroimaging demonstrating injury or a worsening of a pre-existing seizure disorder” (American Psychiatric Association, 2013).

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#NPsychPick of the Month: Use of smartphones and tablets after acquired brain injury to support cognition. Disabil. Rehabil.: Assist. Technol. April 2023

NPsych Pick of the Month: April 2023

Use of smartphones and tablets after acquired brain injury to support cognition

Journal: Disability and Rehabilitation: Assistive Technology, 2023

Objectives

To describe the use of mobile devices after acquired brain injury (ABI), from the perspectives of injured individuals and significant others, and to examine factors associated with mobile device use for cognition.

Methods

Cross-sectional study with 50 adults with moderate/severe traumatic brain injury or stroke (42% women; mean of 50.7 years old, 4.6 years post-ABI), and 24 significant others. Participants completed questionnaires on mobile technology, cognitive functioning and the impact of technology.

Results

Of 45/50 adults with ABI who owned a smartphone/tablet, 31% reported difficulties in using their device post-injury, 44% had received support, and 46% were interested in further training. Significant others reported motor/visual impairments and the fear of becoming dependent on technology as barriers for mobile device use, and 65% mentioned that their injured relative needed additional support. Mobile device use for cognition was common (64%), predicted in a regression model by lower subjective memory and more positive perception of the psychosocial impacts of technology, and also associated in univariate analyses with younger age, lower executive functioning, and greater use of memory strategies.

Conclusion

Using mobile devices for cognition is common post-ABI but remains challenging for a significant proportion. Developing training approaches may help supporting technology use.

  • IMPLICATIONS FOR REHABILITATION

  • Using mobile electronic devices (smartphones and tablets) is common after acquired brain injury (ABI) but is challenging for a significant proportion of individuals.

  • After the ABI, close to 50% of individuals receive support in using their mobile device, mostly from family members and friends, but rarely from rehabilitation clinicians or technology specialists.

  • In a sample of 50 adults with ABI, more frequent use of mobile devices to support cognition was associated with poorer subjective memory and executive functioning, greater use of memory strategies, more positive perception of the psychosocial impacts of technology, and younger age.

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#NPsychTeamResearch: Objects with motor valence affect the visual processing of human body parts: Evidence from behavioural and ERP studies. Lucilla C De Mattia. Cortex, Aug, 2022 via NPsych

NPsych Pick of the Month, April 2021: The impact of Covid-19 and lockdown on the lives of people with traumatic brain injury: Do we need an increased focus on the assessment and enhancement of resilience? Campbell and Parrett. NPsych. The Neuropsychologist, 11, 2021.

#NPsychTeamResearch: The impact of Covid-19 and lockdown on the lives of people with TBI. Campbell & Parrett. The Neuropsychologist 11, 2021 via NPsych

NPsych Pick of the Month, April 2021: The impact of Covid-19 and lockdown on the lives of people with traumatic brain injury: Do we need an increased focus on the assessment and enhancement of resilience? Campbell and Parrett. NPsych. The Neuropsychologist, 11, 2021.

Efficacy of Postacute Neuropsychological Rehabilitation for Patients with Acquired Brain Injuries is Maintained in the Long-Term. J Int Neuropsych Soc, Jan 2020

Postacute NR programs provide participants with various tools, skills, and psychological perspectives that they continue to gain from and generalize to real life after program completion, reflecting transformational processes with stable long-term benefits

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