Why Skills Coaching for Brain Injury Survivors?
After a brain injury, life changes. One day, everything is fine, and then suddenly one has to deal with a comprehensive shift in reality – neurologically, psychologically, emotionally, socially and even spiritually. Survivors go from life as “normal” to dealing with deficits that extend into all aspects of their existence.
Without helpful interventions, brain injury survivors have their deficits predominate in their personalities. This often renders them socially unacceptable, awkward and unemployable. Many tend to withdraw and isolate themselves. Others may act out or exhibit behavioral issues. Chan, Hudson & Parmenter (2004) found that it is becoming increasingly evident that brain injury and criminal behavior are linked. Certainly, when left to deal with the complications of brain injury alone, the burden on the individual can be overwhelming. Studies also have shown that the tendency for survivors is to self-medicate with drugs and/or alcohol. In Advances in Mental Health’s research, Chan et al. (2004) suggests an urgent need to consider early-intervention.
Gray Matters Survivor Outreach – Support Services
This program proposes a quality intervention of personal, one-on-one coaching.
Gray Matters Survivor Outreach already provides three monthly support groups in San Diego and North County. The coaches are trained and made available to work with survivors after they leave the hospital or after having struggled with living independently for some time. In reaping the benefits from this coaching program, divergent behaviors can be “nipped in the bud.”
Gray Matters’ coaches can be a genuine resource for people who have recently sustained a brain injury. The coaches are long-term survivors of brain injury themselves. Just their simple presence and understanding serves their partners in helping them to cope! They can share what helped for them in regaining daily living skills and they can help the partners strategize how best to get by in their specific circumstances. Coaches can also rehearse and familiarize the partners with the accommodations that suit their needs, so that they can put them to use on their own. Additionally, they (and the Program Director) can refer the partners to local resources for services.
To further a person’s sense of wellness, survivors need to cope with their condition and approach psychosocial issues. Lerner, (2006) thoroughly articulates the psychosocial symptoms of a brain injury in her book, Gray Matters, Brain Injury, the Inside Perspective. Many of these symptoms (see list below) are less obvious to the average eye, they are enduring and hard to address. Psychosocial distress is emotional, social, behavioral, and psychological. The very act of interacting one on one via coaching will help to identify issues that would otherwise be difficult for the brain injury survivor to be aware of. Once the issues are identified, they can then be addressed with useful interventions.
The following is part of a seemingly endless inventory of possible ongoing psychosocial challenges:
• Increased emotionality
• Poor self-awareness
• Social inappropriateness/awkwardness
• Frequent mood changes
• Feelings of unworthiness
• Involvement with alcohol and drugs
• Inability to inhibit oneself
• Inappropriate behaviors
• Takes too many risks or acts impulsively
• Depression
• Anxiety
• Disintegration of self-esteem
• Loneliness
• Egocentricity/self-importance
• Impulsivity
• Decreased sense of discernment or judgment
• Poor anger management
• Insensitivity or oversensitivity to others
• Unawareness of how actions impact others
• Lessened ability to interpret emotions & read situations
• Easily frustrated
• Lowered tolerance for frustration
• Inappropriate manners and mannerisms
• Inability to understand humor or “size up” situations
• Inappropriately affectionate or unaffectionate toward others
• Impaired ability to see others’ viewpoint (egocentricity)
• Limited insight into own abilities and behaviors
• Limited ability to correct behavior after feedback
• Gets stuck on one thought or behavior
• Apathy
• Is seemingly unmotivated
• Acts fearful
• Gets angry out of proportion to cause
• Is verbally and/or physically aggressive
• Appears anxious or depressed
• Laughs or cries for no apparent reason
• Isolates self
• Seeks attention, even with negative behaviors
• Is demanding
• Is irritable
• Gets tired easily
• Denies problems
• Seems passive and unmotivated
One characteristic exhibited by brain injury survivors is an extreme sensitivity to others. Because of this sensitivity, coaches, or others who have the experience-base to understand their partners, are so important. Oftentimes, the professionals who are interacting with the survivors appear to be cold and distant. Therapists may know the professional techniques, but they do not understand the personal complexities of brain injury, hence, survivors retreat and often isolate themselves from the very individuals who are trying to help them. The introduction of a coach can help to counter such negating experiences.
A coaching relationship can be a catalyst that helps brain injury survivors rejoin the world. In interacting with the coach, they will learn to proactively socialize. Coaches are not administering a professional protocol, they are there because they care and they are there to individualize strategies to work for their partners. Coaches have a feel for what their partners are going through, because they have walked that path themselves and they can be the connection for their partners to find their way back.
Gray Matters Survivor Outreach
Our name serves as a double entendre. We serve to outreach to survivors and we are survivors reaching out. This country is searching everywhere for solutions to brain injury (and is utilizing a lot of the tax-payers dollars). Gray Matters Survivor Outreach, I say a very effective solution is right in front of us. The supply is available in bulk. That is, other survivors.
The intervention of coaching touches areas that are hard to reach (areas such as social skills, personal attitudes, etc.) and if they are not intervened on, they can become problematic. Survivors are more willing to trust someone who has walked the path they are on. In knowing this, the training for Community-Based Skills Coaches involves teaching strategies and interventions, as well as learning to be an “active listener” and other communication skills.
The protocol for Gray Matters’ is empowering for the coaches and serves in healing for the long-term survivors, themselves. “Give, and it will be given to you.” (Luke 6:38). Such restoration can happen in ability to communicate, self-confidence, self-worth and in better socializing. When matches are made, outreach is in process, Gray Matters Skills Coaching presents a win-win relationship.
Heidi Lerner
Founder and Program Director
Gray Matters Survivor Outreach













