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January 5, 2012 Volume 3, Issue 1
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The Weekly Highlights archive is a virtual library of information on recovery. Topics range from peer specialist training and recovery-oriented systems to personal accounts of addiction, mental illness, and wellness. If you have missed a week's publication, check out volumes 1 and 2—more than 70 archived issues are available.

My TBI Experience
by Keith Jamison
My name is Keith Jamison and I am a registered nurse. I have 20 years of experience in health care, which began in Home Health and transitioned to psychiatric nursing for several years. Currently, I work as a nurse educator at the Julian F. Keith Alcohol and Drug Abuse Treatment Center in Black Mountain, North Carolina. Outside of work, I have been involved in youth ministry for about 30 years, and serve as a youth pastor at Living Waters Tabernacle.

Our treatment center recently held an in-service session on Traumatic Brain Injury (TBI) treatment. The goal was to introduce staff to the signs and symptoms of TBI and to update our screening process, encouraging greater awareness and better understanding of the often missed diagnosis. During the training, I was taken back to a time that influenced me so profoundly, it was likely somewhat responsible for my career today.

In May of 1983, a dear friend was about to graduate from high school and looking forward to college like so many of our peers. We belonged to the same church youth group and spent time together in and out of school.

One Sunday morning, my friend was involved in a head-on collision. He was in a coma in the intensive care unit and his prognosis was not good. His brain stem had been severed. The doctors explained how the brain stem tells the lungs to take in oxygenated air. Without this natural function, my friend would surely die. If he did survive, his only hope was to remain in a vegetative state for the rest of his life. They told the young man's family that his injuries were irreparable—there was nothing to do but pray, wait, and see.

For 2 1/2 weeks, we spent many hours at the hospital with my friend, taking turns visiting and talking to him. The doctors encouraged us to speak normally because they weren't sure what he could or couldn't hear or understand. As time passed, he began to slowly wake up. His level of consciousness improved and he started showing signs of increased awareness. The doctors continued to warn his family of severe brain damage and behavioral changes, should he survive.

Miraculously, he regained full consciousness, but there were major obstacles to overcome. Due to the injury, he had to learn to walk, talk, read, and write all over again. Doctors believed he had the comprehension and cognition of a very young child. He had suffered major memory loss and completely forgotten certain periods of time. To this day, he doesn't remember the accident.

After his initial recovery, he was sent to an inpatient facility, where he underwent major physical and speech therapy. I visited the treatment center often, with other friends and family. We would talk with him or help him walk, and I remember the changes in his temperament. He was more apt to become angry, but never terribly violent. Some of his negative behavior would arise from extreme frustration as he tried to form words or complete sentences while verbalizing his thoughts correctly. Other times, he would get mad if you didn't respond to a question with the answer he wanted to hear. At that point, he would just shut down.

While at the center, I had the opportunity to visit other patients who didn't have as much outside support as my friend. I've wondered if I would have pursued another field had I not seen TBI firsthand.

After a few months, my friend was released from the center. Although he had many lingering childlike behaviors, he continued to work diligently on his recovery. Prior to the accident, he had been an active body builder. The discipline was still there, but had to be harnessed in a different way.

My friend eventually exceeded all of his medical team's expectations. He went off to college in Oklahoma and joined a mission group that traveled to Guatemala. Several years later, he met and married a lovely young lady. He now works full time and has a beautiful home and wonderful life.

As the recent presenters at my agency spoke about caring for patients who have experienced TBI, I remembered my friend fighting for his life and independence so many years ago.

The group that presented the lecture brought a few young men who had sustained TBIs. They addressed the crowd and were gracious enough to answer our questions. I noticed many of the symptoms I had seen in patients with similar injuries. The tremors, unsteady gait, and paralysis were all too familiar. But I also saw the determination to be self-sufficient, to live as individuals and be treated with respect. Yes, their lives had changed. They spoke about things they enjoy doing now as well as what they once enjoyed.

There is so much we have yet to learn about caring for and treating people with TBI. What's even more amazing is how resilient people can be after sustaining this type of injury. The human brain is a delicate organ and so much of it—like its ability to heal or compensate for damaged areas—remains a puzzle. Anyone who has been through a TBI experience knows the drive, work, and support needed to recover on any level. But for those who have suffered a TBI, life is not over and all hope is not gone.

Keith Jamison is the Nursing Education Coordinator at the Julian F. Keith Alcohol and Drug Abuse Treatment Center in Black Mountain, N.C. Contact him at keith.jamison@dhhs.nc.gov.

Don't Forget to Register for the RTP Webinar
"Assessing for and Addressing Trauma in Recovery-Oriented Practice"
This session will help practitioners determine when and how extensively traumatic experiences have affected people with behavioral health conditions and how to incorporate that knowledge into their care-planning approach. In a comprehensive discussion on trauma-informed care, presenters will describe a range of supports, implementation tools, and interventions to address the role of trauma in recovery.

Date
January 25, 2012

Time
3–4:30 p.m. EST

Description
Three multidisciplinary practitioners will share their perspectives on the differences between trauma-informed systems and other systems of care, including how trauma-informed assessment incorporates approaches to ensure safety, meet the consumer's needs, and avoid interventions that could recreate aspects of previous traumatic experiences. Presenters include practitioner Kevin Huckshorn, RN, MSN, who will talk about assessing trauma in an outpatient setting; Paula Panzer, MD, a recovery-oriented practitioner who will address trauma-informed care planning; and Eric Arauz, MLER, a member of the American Psychiatric Nurses Association RTP Steering and Curriculum Committees, who will discuss interventions and supports that have helped facilitate his recovery from personally traumatic experiences.

Registration
To register, click here.

NEW! RTP Resource
Preventing Alcohol-Related Problems in the Workplace
The workplace can be an appropriate setting to educate employees and employers about alcohol abuse prevention. Well-designed programs have the potential to reach people and groups that might otherwise be difficult to target, according to an article by Drs. Genevieve Ames and Joel Bennett in Alcohol Research & Health, the journal of the National Institute on Alcohol Abuse and Alcoholism.

In recent years, researchers have evaluated various workplace programs to prevent alcohol-related problems, including programs that promote social health and a positive work environment. Although some studies have reported significant reductions in alcohol use, additional research is needed. Workplace intervention programs could also benefit from a guiding framework, such as the one proposed in this article.

Read the article.

New Year, Fresh Start
A new year always brings the opportunity for a new beginning. Many people start off with a bang, then slowly stray, losing the momentum to keep their resolutions. Here are some tips to help those in the behavioral health community stay the course.

Be realistic by setting one goal at a time, and split your resolution into smaller, more manageable parts. Use the Eight Dimensions of Wellness endorsed by SAMHSA to guide your goals, which could include personal, professional, or spiritual objectives:
  • Social: Make a new friend.
  • Intellectual: Read three books this year.
  • Financial: Save $1 a week in your savings account.
  • Emotional: Keep a weekly journal of your moods and feelings.
  • Environmental: Clear your desk of unnecessary clutter.
  • Spiritual: Seek peace in your daily life.
Check out USA.gov's list of New Year's resolutions and resources.

Update on RTP Curriculums
SAMHSA is supporting Development Services Group, Inc. in its comprehensive work with five professional associations to develop recovery-focused educational materials for their respective disciplines. With the dissemination and implementation of these training manuals, behavioral health professionals will be able to practice recovery principles while enhancing their core personal and professional values. In addition, the organizations serve as a primary example of how practitioners can work collaboratively across professions and more effectively support people pursuing recovery. The table below provides an update for each organization.

RTP Professional Association Curriculum Development
American Psychiatric Association Edited video of introductory module on recovery session at annual IPS meeting; video will be pilot tested as an educational tool.
American Psychological Association Completed first draft of three educational modules.
American Psychiatric Nurses Association Continued follow-up with RTP Curriculum Committee. Collected additional feedback on RTP learning objectives.
Council on Social Work Education Held Steering Committee meeting; planned conference calls to discuss draft training manual.
National Association of Peer Specialists Created rough draft of first curriculum module on basic recovery principles.

The RTP Resource Center Wants to Hear From
Recovery-Oriented Practitioners!
We invite practitioners to submit personal stories that describe how they became involved in recovery-
oriented work and how it has changed the way they practice.
The RTP Resource Center Wants to Hear From You, Too!
We invite you to submit personal stories that describe recovery experiences. To submit stories or other recovery
resources, please contact Cheryl Tutt, MSW, at 877.584.8535,
or email recoverytopractice@dsgonline.com.

We welcome your views, comments, suggestions, and inquiries.
For more information on this topic or any other recovery topics,
please contact the RTP Resource Center at
877.584.8535, or email recoverytopractice@dsgonline.com.


The views, opinions, and content of this Weekly Highlight are those of the authors, and do not necessarily reflect
the views, opinions, or policies of SAMHSA or the U.S. Department of Health and Human Services.