By: Sam Pender, Junior Creative Associate, West Park Healthcare Centre
One West Park Healthcare Centre social worker is using her skills and knowledge to bring Cognitive Behavioural Therapy (CBT) to her clients living with Acquired Brain Injury (ABI) in an innovative eight-session pilot project.
Recognizing a need for skills and strategies to effectively manage anxiety and depression after a brain injury, Amelia Wynter, Social Worker, developed a Coping Skills Group for clients living with ABI using the evidence-based CBT framework.
"I was inspired to develop this group for people living with ABI because I have seen the positive impact of integrating CBT in practice with my clients," says Wynter of her group. "The initial results and feedback has been positive from both participants and co-facilitators."
The CBT intervention was designed for people living with an ABI, which can result from traumatic injury – caused by external force – and organic injury – caused by internal factors or medical issues.
"I wanted to support the ABIBS Day Program's virtual calendar during the COVID-19 pandemic, which is one of the reasons I piloted this program in this service," Wynter says. "Following an acquired brain injury, people often experience anxiety and depression, and CBT is effective for managing these conditions post-ABI."
The goals of the Coping Skills Group are to help clients understand the relationship between thoughts, feelings, and behaviours; to decrease unhelpful thoughts and cultivate coping strategies for increasing positive thinking; and to manage stress more effectively in daily life. Each session introduces clients to new ideas and coping strategies, and includes group discussion, in-session activities to encourage engagement, and action planning to integrate use of CBT coping skills outside of the session.
Understanding the importance of including different perspectives in any kind of therapy, Wynter developed the eight-session manualized intervention group with an intersectional lens. By discussing the impact of ableism on thoughts, feelings, and behaviours and exploring intersectional aspects of identity, participants in the Coping Skills Group can externalize negative, ableist messages, which have an effect on core beliefs that are directly tied to anxiety and depression.
Wynter co-facilitated the pilot of her Coping Skills Group on Zoom in collaboration with Mithika Jegasothy and Colin Ballantyne, Behavioural Support workers from the ABIBS Day Program. The pilot ran from March to May of 2021 with four participants and 100 per cent attendance for all eight sessions.
"This pilot allowed me to assess what worked and what was challenging for clients, including engagement with between-session work, or action plans, which was primarily because of ABI-related memory concerns," Wynter said. "But overall, the group proved to be accessible and impactful for clients."
While any pilot program will likely encounter challenges, Wynter is using what she learned to make the program better for future participants. To help with memory concerns that made engagement in action plans challenging, future groups will incorporate more memory aids as well as facilitator engagement with families and caregivers.
Offering the group virtually through Zoom made the sessions more accessible and feasible for participants to keep up a perfect attendance record. The pilot also demonstrated that CBT can be tailored for people with brain-injury related cognitive impairment, which is what Wynter set out to do.
Wynter is currently updating the group content based on participant and co-facilitator feedback, and the plan for next steps is to offer another iteration of the virtual Coping Skills Group later this year, broadening the scope of attendees from West Park's ABI services.