This article introduces the concept of posttraumatic growth and briefly reviews the limited number of empirical studies on posttraumatic growth in survivors of brain injury. The relationship between posttraumatic growth and psychological understandings of human spirituality is then explored and it is argued that posttraumatic growth is a type of spirituality that is of particular theoretical and practical interest to healthcare professionals. Specific aspects of the situation of people with acquired brain injury are then considered in this light and some suggestions are made for the integration of spiritual care aimed at supporting personal resilience and promoting posttraumatic growth into rehabilitation practice.

Preliminary research supports that acquired brain injury (ABI) can act as a catalyst for positive psychological changes, and that such posttraumatic growth (PTG) increases with time since injury. In this study, posttraumatic growth refers to positive psychological changes in domains including interpersonal relationships, new possibilities, personal strength, spirituality and appreciation for life. This study aimed to identify associations between levels of subjective impairment and depressive symptoms at discharge, and PTG at 6-months postdischarge following ABI. Sixty participants (73% male) with ABI (Mean days of hospitalisation = 32.92, SD = 40.74) were consecutively recruited from an inpatient rehabilitation unit at discharge and were administered measures of subjective impairment (Mayo-Portland Adaptability Index–4; MPAI-4) and depression (Depression, Anxiety Stress Scales; DASS). Participants were followed up at 6-months postdischarge and administered the Post-Traumatic Growth Inventory, DASS and MPAI-4. The results indicated that levels of PTG reported at six months postdischarge were relatively modest and ranged between no to very small degree of change (‘spirituality’) and a small to moderate degree of change (‘a greater appreciation of life’). Level of subjective impairment at discharge significantly predicted overall level of PTG at 6-months follow-up (β =.40, p < .05, sr2 = .28). Further, at 6-months postdischarge, individuals with a greater appreciation for life reported significantly higher levels of subjective impairment (r = .35; p < .01) and depressive symptoms (r = .34, p < .01) at that time point. These findings indicate that individuals who perceive greater functional consequences of their ABI are more likely to experience PTG. Further, the process of reevaluating priorities and values in life after ABI may be associated with emotional distress during the early stages of community reintegration.

Introduction: Research has indicated that individuals may report benefit finding (BF) as a result of experiencing potentially life-threatening traumatic events, such as being diagnosed with cancer or sustaining an acquired brain injury (ABI). No study to date has examined the incidence and correlates of BF in adult brain tumour samples. The present study aimed to investigate the association between BF and demographic and psychosocial variables in adults treated for a benign meningioma. Method: Seventy participants aged 36 to 87 years completed questionnaires that assessed perceived BF resulting from one's meningioma experience, intrusion and avoidance symptoms, emotional wellbeing and perceived quality of social support. Results: 39% of the sample had been diagnosed with their tumour within a 2-year period prior to assessment (‘early’ meningioma subgroup), while the remaining 61% of participants had been diagnosed with their tumour for more than 2 years (‘late’ meningioma subgroup). Almost two thirds (63%) of the sample reported deriving a moderate amount of BF due to their meningioma experience; although different psychological variables were found to be associated with BF according to group status. Whereas greater BF was found to be significantly associated with elevated depressive symptoms in the ‘early’ subsample, elevated BF was significantly positively correlated with intrusions and avoidance symptoms in the ‘late’ subsample. Conclusions: The findings indicate that BF may co-occur in context of both adaptive and positive illusory processes, which is consistent with the Janus-Face model of growth following adversity. The findings also support the use of psychosocial interventions to facilitate psychosocial adjustment following health crises.

Positive psychology (PP) is the scientific study of positive emotion and wellbeing. In recent years, there has been a shift in the focus of PP from understanding the factors that contribute to wellbeing to developing and evaluating interventions to improve wellbeing. This article addresses the question of whether the principles and practice of PP are relevant to brain injury rehabilitation. It is concluded that PP is indeed relevant to brain injury rehabilitation; that much of our current (best) practice is consistent with the principles of PP, but there remain areas where brain injury rehabilitation practice could draw further on the specific methods of PP.

Acquired brain injury (ABI) commonly results in a range of interacting difficulties including regulating emotion, managing social interactions and cognitive changes. Emotional adjustment to ABI can be difficult and requires adaptation of standard psychological therapies. This article outlines a case where cognitive– behavioural therapy (CBT) was of limited effectiveness but was significantly enhanced with compassion focused therapy (CFT). This article describes Jenny, a 23-year-old woman who suffered a traumatic brain injury 3 years prior to attending rehabilitation. Jenny presented with low self-esteem and mental health difficulties. Neuropsychological assessment revealed executive functioning difficulties. Jenny entered a holistic neuropsychological rehabilitation program aimed at improving complex interacting difficulties, receiving CBT as part of this. As CBT was of limited effectiveness, reformulation of Jenny's difficulties was presented to her based on CFT. The CFT intervention employed aimed to help Jenny develop self-validation and acceptance through producing feelings of kindness and warmth. Shifting the affective textures to the self is a key process for CFT. Self-report measures of mental health and self-esteem showed positive changes and the usefulness of CFT for Jenny. Adaptations in the context of Jenny's ABI are discussed. In conclusion, CFT may be useful in conceptualising emotional responses and developing intervention in rehabilitation after ABI, especially because CFT is based on a neurophysiological model of affect regulation that pays particular attention to the importance of affiliative emotions in the regulation of threat-focused emotion and self-construction.

Up to 90% of people with severe traumatic brain injury (TBI) report dissatisfaction with the status of their leisure participation and/or social integration. Yet, there are virtually no studies that have investigated the benefits of interventions that target leisure specifically for this population. The purpose of this study was to determine whether the Leisure Education Program (Carbonneau, Fontaine, & Lussier, 2006) designed to assist people with stroke to engage in meaningful leisure activities, build leisure self-efficacy and promote general wellbeing would have similar benefits for survivors of TBI. We recruited three community-dwelling survivors of TBI to participate in a 10-week leisure program. All three participants reported some benefit in leisure satisfaction and self-efficacy. This extended to improvements in general wellbeing and health-related quality of life for two of the three. These findings suggest that further investigations into the benefits of leisure education for adults with TBI should be conducted.

Background: The Skills To Enable People and CommunitieS (STEPS) Program is a new information, support and skills program that aims to develop sustainable networks of support for individuals with acquired brain injury (ABI) and their families in communities throughout Queensland, Australia. The program adopts a self-management approach and is delivered by trained peer and professional leaders. Aim: To explore the experiences of both peer and lay leaders in the delivery of the STEPS Skills Program and coordination of STEPS Network Groups. Method: A multiple qualitative case study design was utilised to explore the unique experiences of three trained STEPS Program Leaders. Data collection entailed in-depth semistructured interviews with participants and further incorporated routine STEPS Program Leader descriptive data. The data analysis involved a four-stage approach that included assembling the raw case data, constructing case records, producing case narratives and cross-case pattern analysis. Results: Case study narratives were produced to describe participant experiences with the STEPS Program. The cross-case pattern analysis revealed two dimensions of comparison. The first dimension describes the process by which participants became STEPS Program Leaders, while the second dimension reflects the growth outcomes experienced by participants through their involvement with the STEPS Program. Specific growth outcomes are described in relation to the following domains: ‘expansion of social roles and skills’, ‘appreciation of life’, ‘interpersonal relationships and communication’, ‘confidence, personal strength and accomplishment’ and ‘growth in self as a person’. The results are also described with respect to a model that depicts the process of growth through STEPS Program delivery. Conclusion: Posttraumatic growth of peer leaders after brain injury can be facilitated within a therapeutic intervention such as the STEPS Program.