Spring 2012 Edition MAKING - Headway

Spring 2012 Edition
MAKING
Bringing positive change in the lives of those affected by Acquired Brain Injury
Spring 2010 Issue
Making Headway is published by by
Inside Inside
The Neuro-Rehabilitation Introduction to Spring Strategy Edition 2 2
Telling Tales: Telling Joan’s Tales Story 3 3
Making the Linda’s Most Larder out of Community Living 4 5
To The Top A Legal of the View World 6 6
ABI Ireland’s Lobby Community Day in Leinster Based House Neuro-
Rehabilitation Brain Services Awareness Week 2012 8
7
8
Rehabilitation Research of Executive Round up Function
after Brain Injury 11
10
1

Welcome to the Spring Edition of
Making Headway
Welcome to the late Spring Edition of Making Headway! Spring is a time of renewal,
hope and optimism. This year is no exception and fresh on the heels of our most
successful Brain Awareness Week ever (featured on page 8) , there’s plenty to feel good
about.
This edition contains the inspiring story of brain injury survivor, Ronan (page3), whose
own forward-looking attitude has been central to his recovery. We also have a piece
from Linda on how blogging her recipes is giving her new found confidence (page
5). We have a guest article from a firm of solicitors, MacMahon Goldrick, who explain
the legal complexities of compensation (page 6), and plenty of our usual mix of news,
research and features.
Front Cover picture:
(L to R):Kieran Loughran,
Headway CEO at the
Afternoon Tea; Alma O’Grady
(Headway Limerick) at the
Hunt Museum; Ciarán Nolan
and Clodagh McKenna at
the Afternoon Tea; Kate
Lynch, Noel Kenneally, Carol
O’Brien, celebrating National
Brain Awareness Week at
Headway, Ballincollig (Picure:
Tom Doherty); Guests at the
Afternoon Tea; Joe Sherlock
(Headway Dublin)
I hope you enjoy reading it as much as we have
enjoyed putting it together. As ever, if you’d like to
contribute articles, stories, interviews, ideas, please
email me at stablesr@headway.ie
Happy spring and summer!
2
Richard Stables
Editor, Making Headway
Some of the guests at
the Afternoon Tea for
Headway during Brain
Awareness Week
A Message from the Chief Executive
As I write this introduction it looks like
summertime has arrived. The weather is
good, and this can lift everyone’s spirits.
Despite the continuing financial difficulties
that beset the nation, we stay optimistic in
delivering on our mission to bring “positive
change” to the lives of those we serve.
When you scan the horizon for the policies
and strategies that are likely to influence the
shape and or direction of future service delivery there
are two significant documents in the public domain:
the National Policy and Strategy for the Provision
of Neuro-Rehabilitation Services in Ireland and the
recent report entitled “New Directions – Personal
Support Services for Adults with Disabilities”.
The Neuro-Rehabilitation Strategy, which we
anticipated in our last issue of Making Headway,
is disappointingly aspirational. Whilst it is a good
summary of an ideal system of service provision, it
contains no particular timelined actions and contains
little reference to life in the community which, after
all, is where most people with brain injury will spend
most of their lives.
The New Directions document is particularly relevant
to Headway and the work we do. It articulates twelve
personal supports that should be available for adults
with disabilities who receive a person-centred
service. The report acknowledges that there is no
free-flowing continuum in brain injury services from
trauma to community re-engagement anywhere
in the country. However, I do believe that Headway
performs very well on many of the measures within
the geographical areas in which we operate, within
the resource constraints. Once again, the report
points to the need for greater collaboration in
services, not only between voluntary organisations
but also across the full range of state services.
On other news, Headway’s National Advisory Group
of service users, comprising representatives of
service users from Dublin, Cork and Limerick met
with the Headway Board in February and a very
positive engagement took place. This will become
a regular and committed meeting. We are also
pressing on with the preparation for accreditation
which has at its core person-centredness. Our
staff continue to demonstrate great commitment,
flexibility and creativity.
Finally, I wish all a good spring and summer.
Kieran

Making Headway Spring 2012
Telling Tales: Forward Focus
Ronan suffered a horrific horse-riding accident shortly before his leaving cert year. Fracturing every bone in
his face and with a bleed to his brain, his parents were told to expect the worst. Fifteen years on, and following
extensive reconstructive surgery, he has made a recovery which you could describe as almost miraculous. But
a recent decision to take a Masters degree in Business Administration (MBA) made him reflect on his head
injury and his ability to achieve his goals. He talks in this interview to Headway’s Richard Stables about his
forward focus and its importance in his continuing recovery.
When was it that you first started to wonder about
how you were doing
There were a couple of stages. In my physical
recovery, about six or seven years after the accident
I met someone who had been injured in a motorbike
accident. He recommended an osteopath to me who
very quickly was able to take away a lot of stiffness
and pain in my back which allowed me to focus again
on getting physically fit. I’ve worked hard from that
point and now I jog regularly. In terms of my mental
recovery, it was my girlfriend who suggested that I do
a Masters in Business Administration (MBA).
I thought it wasn’t a bad idea but I got to thinking:
ok, well tackling an MBA with a head injury is a whole
new level of challenge; will my level of ability
or concentration be up to it
So I started thinking about head injury. I’d
read in Making Headway about a story of
recovery similar to mine, and I thought: I
should probably do the course, but will I be
able for it Anyway, I applied for the course,
was accepted a week later and before I knew what
was going on I was starting an MBA.
And did you have any difficulties MBAs are
notoriously intensive courses.
Yes, I did have difficulties concentrating. I found
that when someone asked a question, instead of
paying attention I was already off on a track of “well
I know the answer to this” before the questioner had
finished. I’m not sure if I would have had that problem
with concentration beforehand, but I’m a creative
thinker which can mean you are naturally inclined
to hop around the place. No matter how hard I tried
to adapt and concentrate, I couldn’t alter this lack of
concentration. This gave me pause for thought.
So, what made you come to Headway
Part of the MBA involved a module of personal
development. The idea was to survey people around
me and figure out where my key weaknesses are in
my professional life. It turned out that I had two areas
I had to work on: Stress and creative problem solving
– both these areas were personal weaknesses rather
than professional. I honestly didn’t think I had stress,
but when I started looking into it I realised I did have
stress, not so much to do with work but to do with
things like managing money, which I believe people
with head injury can sometimes have issues with.
Also, the stress wasn’t allowing me to think through
problems. I would make very quick decisions but
without thinking through the problem. So that got
me thinking about my head injury.
You came to us with questions about your
functioning – what did you get out of it
I found out a lot about my accident. Until then, all I
knew was that I had broken bones and
a head injury. I had all sorts of false
memories of the period immediately
after the accident, thinking I’d just had
a bang on the head and I was fine. In
fact, I’d no idea that months had gone
by and I hadn’t a clue where I was.
It was interesting to do the psychological tests and
learn about my strengths and weaknesses. I learned
that my long term memory and my hearing memory
were fine, but my visual processing wasn’t so good
which explained why I had difficulty remembering
directions for driving. It gave me a lot of information.
Beforehand I had presumed the news would be all
bad, but there was a lot of positivity to come out of
the assessment. I’d also been experiencing flashbacks
to the time of the accident, and those have resolved
now.
How has that understanding impacted you
I don’t know that understanding what happened
to me has had a big impact. I think it has had more
of an impact for other people. To be honest I think I
was a bit immune to it myself- I didn’t even know this
information was there. My focus has always the whole
time been forward, getting back to school, doing my
leaving cert and focusing on the physical recovery.
3

Has that forward focus been helpful for you
Absolutely – I believe it is the reason I made the recovery
that I did. I very quickly accepted the situation as it
was and sought to make the best of it. Probably more
so than anything else, I think that’s why I recovered to
the extent I did, no looking back or “sorry is me”. My
girlfriend sometimes asks “Do you ever think about
what could have been if it didn’t happen” - I just don’t
think like that. I look at me prior to the accident as a
curiosity, particularily as I get older. The post-accident
Ronan is almost as old as the pre-accident Ronan now,
and I find that whole concept very curious.
And what does the future hold
I’ve finished my MBA, work is going well, I work for
a growing company, and I’m getting married later in
the year. It’s all good. Exercise is also a big part of my
life and I believe the focus on running longer or faster
than I have done before is my attempt to control my
physical recovery. I was an athlete before the accident.
My next dream is to run the marathon. My longest run
this year so far is 18k.
Is the Head Injury in the past, or something you
keep with you
The head injury is part of who I am. It’s as much as
part of me as, say, being Irish. I wouldn’t be who I am
without head injury. My short haircut doesn’t hide the
scars and I believe it has helped mould me into who I
am today. It’s always going to be there. I’m probably
now interested in it more than I ever was. I don’t regret
it.
I know I’m lucky, I’ve been in clinics and I’ve seen other
people who haven’t been as lucky. There’s a lot of
hardship for families. My own parents thought I was
gone. My heart had stopped; I had MRSA, pneumonia,
the works. It was the forward thinking that got me
through it I believe.
My forward looking approach - It does work and it is
what I’d like to pass on to other people. I don’t believe
I would have got better looking backwards or looking
back at the accident and focusing on why it happened
or what if I’d done this or that . The fact is, it happened.
End of. Now it’s all forward moving whether physically,
mentally or career-wise.
Poems
Here are two poems from brain injury survivors. Helen McMahon
attends our vocational programme in Limerick and Anthony
McGann uses our Community Integration service in Dublin.
Flow of Life, by Helen McMahon
Headway, by Anthony McGann.
Like the ebb and flow of the tide
Like the crest of a wave
Our lives start and end
With highs and lows throughout.
The secret is to realise the moment
And to treasure them.
Pass on a little kindness
And learn from our mistakes.
To all of you who are up
Help those who are down.
To those of you who are down
Reach out and ask for Help.
Life is getting scary
Tragedies do happen
Nature is powerful
Look for the answers within
Peace and Harmony will reign again.
4

Making Headway Spring 2012
Linda’s Larder
Linda’s Larder is a new series of food recipies by brain injury
survivor, Linda. Headway’s Elisa O’Donovan chats to her
about food, blogging and how it helps her recovery.
Tell me a bit about yourself
My name is Linda. I’m 34, I’m from Blanchardstown
and I acquired a brain injury a number of years
ago after a road traffic accident. I have always had
an interest in cooking ever since I was young. My
favourite thing about cooking is seeing the smiles
on people’s faces, and empty plates, when I serve
them a dish.
Sometimes I find it quite difficult to follow recipes
since my brain injury, especially when it comes to
exact measurements. I find all the different weight
measurements really confusing! Because of this I
don’t follow recipes rigidly, and I make up my own
style and recipes. I think food should be fun, and
should be played around with. My brain injury
has probably made me more adventurous when it
comes to cooking, and I think this is a good thing!
How did Linda’s Larder come about
It was Elisa who first suggested it to me. She had
arranged to meet me at my house, and I had some
of my chicken pasta lunch ready for her when she
arrived. Elisa told me that she thought it was better
than anything she’d tasted in a restaurant. She was
asking me had I ever had professional training as a
chef, as she thought the food was that good! It was so
great to get that positive feedback from someone.
got from all the staff was so overwhelming, as they
seemed to all love my food, especially my nut and
chocolate cookies.
Has publishing Linda’s Larder helped you along
your individual brain injury journey
It really has. I think sometimes when you have a brain
injury your confidence can be knocked a bit. People
don’t understand the difficulties that you face and
how much harder things can be. That’s what I like
about cooking. It is just me alone in the kitchen. I
can take my own pace, and take things slow.
Having such positive feedback from Elisa, and seeing
the blog on screen has given me a huge confidence
boost. I feel that there are opportunities out there
for me, and that I have talents and skills that I should
nurture.
You can read this mouthwatering recipe and more
of Linda’s Larder at her blog at
www.headway.ie/brainblog/author/lindaslarder/
We started talking about food and cooking, and Elisa
suggested that I write a recipe blog for Headway’s
website, and Linda’s Larder was born!
How did it feel when you got your blog
published
I was very excited about starting the food blog, as I
thought it would be a great platform for me to get
my ideas and recipes out there to a wider audience.
It has always been my dream to open up my own
cafe, and this felt like a first step to being recognised
as a good chef.
Elisa came out to my house one Friday afternoon,
and I had cooked three dishes for her. We took
pictures and Elisa brought all the food back to the
Headway offices for taste testing. The feedback I
One of Linda’s recipes, the scrumptious Chocolate Nut Cookies
5

A Legal View
by MacMahon Goldrick Solicitors
Jessica Goldrick
Any claim for compensation arising from a brain injury can be
complex and a number of issues arise that are novel or unique to
this type of injury. Many of these issues arise due to the complexity
and uniqueness of the human brain. Further issues arise from
the fact that it can be difficult in the short term to establish the
consequences that arise from a brain injury. Indeed problems
can develop some time after the initial brain injury.
6
Every case for personal injury requires the use of
expert witnesses in order to provide evidence relating
to the consequences of such an injury. A number
of experts are required in the preparation of brain
injury cases that are not normally used in a standard
personal injury case. These for example can include
neurologists, neurosurgeons, neuropsychologists
and rehabilitation consultants.
The brain is a unique organ and the effect of brain
injury will differ depending on the area of the brain
affected and the individual concerned. Different
people can react differently to a similar injury. From
a legal and medical perspective, a one size fits all
approach is not appropriate where the brain is
concerned and a case should be built around the
individual taking the case. In order to deal with
late onset difficulties, a solicitor should have regular
meetings with the client in order to record any
changes that the person experiences. The solicitor
should also ensure that all of the experts are updated
with new instructions and that reports are updated
to take into consideration any changes that the
person experiences. A solicitor should be aware of
all of the physical, cognitive or emotional changes
arising from a brain injury.
The legal process can be time consuming and this
is particularly the case in brain injury cases. The
consequences arising from a brain injury are not
always immediate and it can take a period of time
before a clear medical prognosis becomes available.
A case can finish in one of two ways. It can settle or
it can go to hearing, in which case a Judge sitting
alone will hear the evidence and make a decision as
to whether or not to award any compensation and
also the amount of the compensation. When cases
settle, they tend to settle at an advanced stage when
a lot of preparatory work has already been done. Any
settlement reached or Court judgment (subject to
appeal) is final and it cannot be revisited afterwards
even if new medical evidence subsequently comes to
light. This is why it is important that as clear a medical
prognosis as is likely to be available is secured before
any brain injury case is heard or settled. It is helpful
if the solicitor provides a guideline to his/her client
at the beginning of the case as to the steps involved
in taking a case.
Another issue that is unique to brain injury cases is
that brain injuries do not always show up on MRI
scans or other scans. So called “mild” traumatic
brain injury can have severe consequences for the
individual concerned and this type of injury can
often go undetected in standard scans. This is where
neuropsychologists and rehabilitative doctors
have an important role to play as they can provide
evidence as to the affect that the injury has had on an
individual and whether that injury is consistent with
a brain injury. Scanning technologies are improving
all of the time and it is to be hoped that in future
“mild” traumatic brain injuries will be discernible in
scans but this is not a realistic option at present.
It is regularly the case that the Defendant in a case
will have insurance and in these circumstances
the insurance company appoints a solicitor to deal
with the case. The insurance company and not the
Defendant will have to pay any compensation.
An insurance claims handler will work on the case
in conjunction with the solicitor. The more the
insurance claims handler and the Defendant’s
solicitor know about brain injury the better as it will
enable them to appoint the appropriate experts and
value the case properly. This is important as it avoids
delays in having the case heard and it will also
increase the likelihood that any settlement offer is
an appropriate amount. In some instances it is up to
the claimant’s solicitor to “educate” the Defendant’s
solicitor as to the nature and seriousness of the
brain injury and he can do this by ensuring that all
information relevant to the brain injury is disclosed

during the pleadings stage. Pleadings are written
documents that are exchanged between a Claimant
and a Defendant in legal proceedings.
If the case does go to Court, a Judge will hear the case
and the relevant evidence. The Judge may or may
not have a lot of experience in hearing brain injury
cases. It will be the responsibility of the claimant’s
legal team to inform the Judge as to the seriousness
of the brain injury and its consequences. When a
case is being taken, it is useful for the person who
has suffered a brain injury to keep a diary recording
their experiences of living with a brain injury. It is
also beneficial if a close family member does the
same thing. This can be useful in providing his/her
legal team with a better understanding of the effect
Making Headway Spring 2012
that the injury has had on their day to day life.
The most important thing for an individual who is
taking a case following a brain injury is that they
take care of their health and avail of whatever
rehabilitation services that are available. It is
important that they put their energies into the
rehabilitation process. Returning to work (if this is
possible) can also be an important factor in assisting
someone in their recovery. If someone feels that they
are able to return to work before their case is heard,
they should, subject to medical advice, make efforts
to do so. It may also provide useful information
as to the likelihood of a full time return to work or
indeed whether an alternative career path should be
pursued.
Lobby Day in Leinster House
This February, Headway service users and staff
from centres around the country joined charities
from across the neurological sector to lobby TDs
and Senators in Dáil Éireann. The aim of the day
was to make public representatives aware of the
important role played by service providers such as
Headway in the lives of the thousands of people
with neurological conditions in Ireland.
Over 45 TDs and Senators attended the briefing,
during which representatives heard that:
• Just one in six people requiring specialist
rehabilitation for neurological conditions are
receiving the services they need to rebuild their
lives.
• According to the Neurological Alliance of
Ireland (NAI), community services provided by
neurological charities are “in crisis” following
funding cuts in recent years of up to 12%.
• The health service’s own data shows that in
2010 just 2,510 out of 15,000 people requiring
specialist rehabilitation services for conditions
such as acquired brain injury, stroke, spinal cord
injury, MS and Parkinson’s actually received vital
treatment.
Neurological Alliance of Ireland chairman, Chris
Macey said: “This is like Russian Roulette in reverse.
For every person who receives the services that
could enable them get their life back maybe from
a brain injury sustained in a car crash, from a
stroke, or from the onset of a serious neurological
condition, five will be left with no service and in
many cases no hope at all.”
Headway Limerick Service Users Tom Griffin and Robert
Edmonds at Leinster House
Headway was well represented at the event and
would like to thank the service users and staff who
turned out on the day to help get the message
across, some of whom had travelled long distances
to be there. Thanks to Kay, Phil, Michael, Tom,
Robert, David and Alan.
The group of representatives from Headway and the
Neurological Alliance of Ireland
7

Congratulations!
Earlier this year, a number of trainees in the
Clondalkin Rehabilitative Training programme
successfully completed FETAC Level 3 modules in
FETAC Personal & Interpersonal Skills and FETAC
Food and Cookery. Every person did Trojan work
towards completing their folders.
The Personal and Interpersonal Skills module
enabled the learners to develop a sense of selfknowledge
& self-awareness, to undersand
and demonstrate decision making skills and
Singing our Hearts Out
Service users from Headway Cork recently took
part in a singing workshop with Cork Sacred Harp
Community Singers. Sacred Harp is based on a 300
year old style of singing called Shape Note and is all
about people coming together as one to express
themselves through song.
“It was a very powerful, fun and uplifting experience”
commented Headway’s Paula Larkin.
The workshop took place at the Camden Palace
Hotel, which is a volunteer-run artist and community
space in Cork City (see www.camdenpalacehotel.
org/). More information about Sacred Harp can be
found at http://corksacredharp.com. The photos
In Dublin, the week kicked off in style with guest
presenter, TV Chef and food writer Clodagh McKenna
joining us to host our Afternoon Tea Party which was
held in the Davenport Hotel. An impressive array of
goodies was on offer, prepared by the Headway staff
for the one hundred guests. Clodagh entertained
us with her cupcake icing demonstration and some
useful gastronomic tips. The event also managed to
raise over €800.
In the Rehabilitative Training service in Finglas, Dublin
a grand total of € 730 was raised by canteen staff in
Colaiste Ide and users of the service who held a raffle
and sold their handmade jewellery and greetings
cards. In between classes and bouts of fundraising,
the service users also managed time to give talks to
communicate assertively. All of these skills are
necessary for many work, social and life situations.
Congratulations to Alan Byrne, Michael Comisky,
David Kennard, Dean Courtney and Kay O’ Brien.
The aim of the Food and Cookery module was to
develop the skills needed to prepare and serve a
variety of meals and to work as part of a team. The
people who were successful at completing this
module were Dean Courtney and Derek Cross.
were taken for us by Marcin Lewandowski from
www.soundofphotography.com.
The Sacred Harp Singing Workshop -
photo by www.soundofphotography.com
Brain Awareness Week 2012
Brain Awareness Week ran this year from March 5th to 11th. As in previous years, it saw Headway service
users, families and staff pull together in a huge number of activities to help in the quest to raise awareness
about brain injury and the services and supports available.
several groups of students. Congratulations to all!
There were information stands aplenty, in Liffey
Valley shopping centre; Stephen’s Green shopping
centre; Blanchardstown Hospital; the Mater Hospital;
Beaumont Hospital and in Clondalkin.
In Cork, Headway’s psychological and social work
services organised a stand at the Mercy Hospital
which was manned by Headway staff and by family
members of service users. The service also held
an information/coffee morning for staff members
from local family resources centres. Along with tea
and cake, they provided a general overview of ABI
and Headway services. Yet more information was
available through a stand in CUH and a talk to a
secondary school.
8

Making Headway Spring 2012
In Limerick, culture was the order of the week, as
the third annual art exhibition in the Hunt Museum
showcased the creative talents of the Headway
artists. In addition, there were presentations and
information stands at the train station and the
Crescent shopping centre and in UL. At Dunnes
Stores in Childers Road Headway clients sold over
three hundred trolley tokens to raise awareness.
A talk about brain injury to professionals was also
given from Headway’s Limerick centre in Steamboat
Quay.
Karen Foley from Acquired Brain Injury Ireland and
Meadhbh Lysaght from Beaumont Hospital at the
Information Stand at Beaumont Hospital
Sean and Angela Young enjoying the treats at the
Afternoon Tea
In Cobh, the Day Service attendees took part in
a tournament of Boccia, a popular sport with
wheelchair users based on the French game, Boules.
Not to be outdone, the clients in the Mallow Day
Service went on an outing to play bowls. In Carlow,
a joint coffee morning held with Brainwave, the
Epilepsy organsation ensured that everyone was
getting enough refreshment whilst learning about
brain injury and epilepsy.
Dog Track Fundraiser
On the night of the 22nd March, Headway Cork
staff and clients held a fundraising night in the dog
track. A great night was had by all and some even
managed to go home with more money than they
came out with! While some people “studied the form”
carefully and meticulously before placing their bets,
others chose their dogs based on their name, where
they were from or their number and both methods
had their own degrees of success! In total the night
raised €980 and Headway would like to thanks all
those who contributed to making it a great success!
The events during the week weren’t just limited to
local community activities. Some serious notes were
struck during the week by the National Conference
hosted by the Neurological Alliance of Ireland,
entitled “Securing Resources for Neurological Care
and Rehabilitation in a Recession”.
Opening the conference, Mr Chris Macey, Chair
of NAI, spoke of the effectiveness of non statutory
organisations as advocates for change, as service
providers and as key partners in transforming
neurological care services. This was followed by
presentations from the clinical directors of each
of the national programmes in Stroke, Neurology,
Rehabilitation and Epilepsy. The afternoon session
focused on supporting non statutory organisations
in lobbying and campaigning with presentations
from Amnesty and the Alzheimer Society of Ireland.
With such a concentrated amount of activity out
and about in all the local communities where
Headway is based, we are confident that with each
passing year of Brain Awareness Week, the message
keeps spreading about brain injury and the unique
challenges it poses.
Thanks to everyone who participated during the
week and supported us in helping people become
more aware of brain injury. Keep spreading the
word!
Headway’s Carol O’Brien and family enjoying a night at
the dog track
9

10
In everyday life, if we say that someone has low
self-awareness, it can be easy to assume that this is
somehow their own fault. But with a brain injury, the
very mechanisms that allow us to become aware of
ourselves and to gain insight into our own situation
can be compromised. So, to what extent does having a
brain injury impact self-awareness and what difficulty
does this pose for people in their recovery These
pieces of research shed some light on the area.
Dirette, D.K. & Plaisier, B.R. (2007) The development
of self-awareness of deficits from 1 week to 1 year
after traumatic brain injury: Preliminary findings.
Brain Injury. 21 (11), 1131-1136
In the case of brain injury, self-awareness means the
ability to accurately recognise the problems caused
by the injury. Neural damage after a brain injury can
frequently lead to impaired self-awareness. Such
deficits in self-awareness can have a negative effect
on the achievement of successful rehabilitation. This
study aimed to examine the development of selfawareness
over time after a traumatic brain injury
(TBI). 18 participants who recently experienced a
brain injury took part in the research, which involved
both the person and their significant other being
interviewed 1 week, 1 month, 4 months and 1 year
after their injury.
The research found that people with a mild TBI
displayed an accurate self-awareness throughout the
first year after injury. However people with a moderate
to severe TBI tended to overestimate their cognitive
abilities until one year after their injury, at which point
they rate their cognitive functions similar to the ratings
of their significant other.
So, the conclusion was that family members of people
with moderate to severe TBI require time to develop
their own awareness of the person’s difficulties
following brain injury but this awareness develops
sooner than the person’s self-awareness.
Fotopoulou, A., Rudd, A., Holmes, P. & Kopelman, M.
(2009) Self-observation reinstates motor awareness
in anosognosia for hemiplegia. Neuropsychologia.
47 (5), 1256-1260.
Hemiplegia is an inability to move the muscles on one
side of the body, and can occur after experiencing
a brain injury. Situations can arise when a person
suffering from hemiplegia will falsely believe that
Research Round Up: Self-
Awareness After Brain Injury
This edition’s Research Round Up addresses the very
complex area of Self-Awareness. Ciara Brien and Cillian
McCormack-Doyle guide us through three relevant pieces
of research literature.
they can move their paralysed limbs. This symptom
is termed anosognosia for hemiplegia. Our second
article reports a case study which demonstrates the
effect of “third person” perspective on a person’s selfawareness
of physical limitations.
A 67 year old woman who had suffered a large right
sided middle cerebral artery stroke was the subject of
this case study. At 22 days after her injury, despite an
acknowledgement that her left side was weaker than
her right, her lack of awareness of her left upper limb
paralysis persisted. She was then shown a 90 second
video clip of her answering general questions about
her limb functionality and being asked to perform
specific actions with her impaired (left-sided) limbs.
This more remote and objective viewing of her own
inability to perform the requested tasks resulted in
immediate and full self-awareness of her left sided
paralysis, with this awareness still intact at a 6 month
follow up.
Lundqvist, A., Linnros, H., Orlenius, H. & Samuelsson,
K. (2010). Improved self-awareness and coping
strategies for patients with acquired brain injury—A
group therapy programme. Brain Injury, 24(6), 823-
832.
Self-awareness has been proposed to consist of
intellectual awareness (being able to describe your
difficulties), emergent awareness (being able to notice
when you are having difficulty) and anticipatory
awareness (being able to predict in advance what
situations will be difficult). Anticipatory self-awareness
seems to be a prerequisite for developing good
coping strategies after a brain injury, as people have
to be aware of what type of situations they might find
difficult, before they can plan for these situations. The
authors of our final article sought to determine if a
group therapy programme could help individuals with
brain injury to develop anticipatory awareness and
coping strategies.
The programme focused on learning to recognize in
advance when, and in what situations, the individual’s
problems were likely to occur. The programme
also aimed to provide the participants with a safe
environment to talk about themselves, experience
peer support, get feedback from one another and
practice strategies. The authors ran three therapy
groups and assessed the impact of these groups
using questionnaires, interviews and focus group
discussions.

The results showed that a structured group therapy
programme can help patients with acquired brain
injury to understand the consequences of their
neuropsychological difficulties, improve awareness of
these and develop and implement coping strategies.
Attending the group also had a positive effect on their
life and work situation and on their self-confidence.
If you would like to learn more about Headway’s peer
support group, called the Harbour Group, please contact
our Information and Support Line on 1890 200 278, or
via email at helpline@headway.ie
New Headway Day
Rehabilitation
Service in Cobh
This year, in response to local need, Headway set
up a new day rehabilitation service based in Cobh.
Day Service Officer, Jennifer Cotter writes about the
adventure...
‘’All journeys begin with a simple step’’. A new year
and a new service in Cobh was an adventure I and
my co worker Jean were very much looking forward
to embarking on. We are now based in Cobh Parish
Centre every Wednesday; the group are a combination
of new clients and three clients who have been
attending Headway services for a number of years in
our Ballincollig centre. One detail bonds the entire
group; they are all extremely proud Cobh men. Our
days are often filled with interesting stories and facts
about the locality and the rich history of the island.
Thank you! Thank
You! Thank You!
We want to say a huge big thanks to the following
people:
Dermot O’Brien from O’Brien printing for their help
with our 2012 calendar; St. Belinda’s College and
the congregation of St. Brendan’s Church Coolock
for their generosity; also to Edel Hyland for raising
Your Quality
Feedback Counts
The quality of the service we provide is really important
to us. This year, Headway have started preparation
to apply for a quality standard administered by
an organisation called CARF (the Commission for
Accreditation of Rehabilitation Facilities–www.carf.org).
One way for us to improve our services is to listen hard
to the people who count. That’s you! Whether you use
our service or whether you have an opinion about how
Making Headway Spring 2012
Research Extra:
Congratulations to Michelle Murphy in our Limerick
centre on the recent attainment of her Masters Degree
in Cognitive & Behavioural Therapy with the Irish
College of Humanities and Applied Sciences. Research
undertaken by Michelle for her degree explored the
experience of counsellors who work with survivors
of acquired brain injury and looked at the impact on
counsellors of working with this group of people. An
article based on her recent research, which may be of
interest to counsellors and psychologists working in
the field, will be available on the Headway website.
The Community of Cobh have made us feel very
welcome. We are so grateful to the Parish Centre and
the Community Hospital for all their support for the
new service. During Brain Awareness Week, a Boccia
Tournament between the hospital and Headway
proved to be a great success. It was a close game but
in the last round the Headway team were victorious
and brought home gold medals! We plan to defend
our title in a rematch during the summer months.
Headway Cobh service users enjoying the Boccia
Tournament
funds for us in a cycle ride on the other side of the
world (Australia); to Malcomson Law for ongoing
relationship and support; to Mark Brady of Square
Design for help with our annual report; to Glen Power
of The Script, Clodagh McKenna and The Davenport
Hotel for their support and finally...
to all our supporters, donors, service users and family
members.
Thank you!
we might do things better, differently or even not at all,
we will be seeking your feedback. This might be in an
anonymous survey or a focus group or a meeting but it
could also be through a method which you choose. If
you have something you’d like to tell us about how we
are doing, please let us know and contact us at email:
info@headway.ie, telephone 1890 200 278 or write
to me at the address for Cork Psychology & Family
Support Services on the back page. All feedback, ideas
and suggestions are welcome and will be forwarded
to our quality team.
Christine Flynn
CARF Coordinator
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Making Headway Spring 2012
Contact Information
Head Office
Unit 1-3 Manor St. Business Park, Manor St., Dublin 7
Tel: (01) 810 2066 Fax: (01) 810 2070
Web: www.headway.ie Email: info@headway.ie
Information and Support Line
1890 200 278
email: helpline@headway.ie
Monday – Friday, 9 am to 1 pm and 2 – 5 pm (local call rate)
Dublin Office
Unit 1-3 Manor Street Business Pk, Shea’s Lane,
off Manor Street, Dublin 7
Tel: 01 810 2066 Fax: 01 810 2070
Web: www.headway.ie Email: info@headway.ie
Rehabilitative Training & Day Rehabilitative Services, Employment
Support, Community Reintegration, Neuropsychological
Assessment, Psychotherapy, Counselling and Information and
Support.
Cork Office
Unit B3, Link Road Business Park, Ballincollig, Cork
Tel: 021 487 1303 Fax: 021 487 1305
Rehabilitative Training & Employment Support,
Rehabilitative Day Services and Community Integration.
Cork Psychology & Family Support Services
Kenny Group House, Carrigrohane Road, Cork
Tel: 021 434 7625 Fax: 021 434 7477
Brain Injury Rehabilitation, Neuropsychological Assessment,
Psychotherapy, Counselling, Family Support,and Social Work
Services.
Limerick Office
Jutland Hall, Steamboat Quay, Dock Rd., Limerick
Tel: 061 469 305 or 061 469 306
Rehabilitative Training, Vocational Training Programme,
Supported Employment, Neuropsychological Assessment,
Psychotherapy,Counselling and Family Support
Kerry Office (Psychological Services)
Fairies Cross, Clounalour, Tralee, Co. Kerry
Tel: 066 711 9320 Fax: 066 711 9321
Psychotherapy and Counselling
South East Office
15 Old Dublin Road, Carlow
Tel: 059 9134029
Information and Support, Family Support
Upcoming
Events
Run for Headway – Following an appeal by Glen
Power of the Script we are asking supporters
to consider running for Headway in one of the
marathon and mini marathon events around the
country. See www.headway.ie/runforheadway
Monthly Carers Group Dublin – We operate a
monthly support group for family members and
carers of people with brain injury in our Dublin
centre. Check our website for details of the next
date
Beach Cleanup – as part of Coca Cola Clean
Coast Week, on May 11th we are taking part in an
educational tour, and beach cleanup of Bull Island.
So if you have a passion for environmental issues,
or want to enjoy a sociable morning in the fresh
air, then this may be just be the event for you. This
event is open to Headway service users. For more
information on how to get involved please contact
Elisa on odonovane@headway.ie or 086-1072597
Dublin Staff Relay – 24th May Once again, our staff
team of intrepid runners will compete in this fun
race to be held in the Phoenix Park. All sponsorship
is welcome, contact Ciarán on 01 810 2098
Charity 25 Golf Classic and Ball – A golf classic
will be held on Tuesday 3rd July at a leading golf
venue in Leinster (to be confirmed). The Mrs
Brown Charity Ball will take place on Sunday
16th December at a Dublin hotel venue (to be
confirmed). Headway benefits from your support –
see our website for more details
Limerick Golf Classic and Annual Ball – keep an
eye on our website for more details
For up to date listings, please check
www.headway.ie/events
Find us on Facebook at
www.facebook.com/Headway.ie
Follow us on Twitter at
www.twitter.com/HeadwayIreland
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