Recovering social participation - experience with a relational group intervention for traumatic brain injury patients.

Background: Traumatic brain injuries often result in impaired social functioning that may cause uncertainty, isolation, and precipitation of significant stress in social situations. Involvement in directed group treatment helps participants to develop new capabilities for feeling relationally connected, improving verbal and nonverbal communication skills, as well as building the capacity for empathic intersubjectivity. We suggest that group intervention to improve communication and social skills may provide an efficient and effective way for a patient to return to successful social participation.

Objective: The purpose of this paper is to describe and discuss the principles of a clinical group intervention for increasing the social participation of persons with traumatic brain injury.

Methods: Since 2000, several intervention periods, each with 10-20 group meetings, including some individual sessions for guidance, have been carried out under our direction in Finland. The intervention periods include education, reflection, and practical experiential exercises and can be multidisciplinary with both speech-language pathologists and neuropsychologists providing oversight and direction. The main goal of the described group interventions is to support community participation and social reintegration. In this article, we describe guiding principles and provide examples of the clinical group interventions drawn from our experience.

Conclusion: As determined by clinical observations and patient reports, the group intervention for social participation has proven to be beneficial. The participants report gaining more understanding of and insight into social situations, nonverbal and verbal communication, as well as affective interactive experience. Practicing social skills in a group situation is inherently self-motivating and encourages a constructive, positive impetus toward greater social participation. Based on our experience with this approach, it appears that this experiential form of group intervention is an effective bridge between structured cognitive-communication rehabilitation and successful real-life social participation.