Interview with Dr. Robert Fraser

Meet the editor and contributing author of Living Life Fully After Brain Injury:

Dr. Robert Fraser 

LASH:   Based on your experience, what do you think are three major issues survivors deal with over time?

FRASER:     The challenges that survivors face generally correspond to the severity of their injury. As injury severity increases, many are substantially challenged in engaging in and maintaining meaningful relationship, functioning in competitive employment, and learning to accept and love themselves as they are. This self-acceptance piece is huge because if it doesn’t happen, it is often very difficult for the survivor to move beyond significant despair to make adaptive progress. Drs. Bell, Johnson, and myself are very much in agreement on these concerns. 

LASH:   With so many rehabilitation facilities placing tighter restrictions on in-patient stays, what impact has this had on the recovery of patients with TBI? What’s the impact on their families?

FRASER:     With the significant shortening of inpatient stays, family members and significant others are forced into this very rapid period of adjustment as is the survivor. There is often a frantic search for resources which can be extremely difficult for significant others as they strive to balance care for the survivor, medical appointments, work, childcare, and life’s diverse demands. Since caregivers and significant others can become emotionally and physically drained, their needs, as well as those of the survivors, were carefully considered in the development of this Workbook. 

LASH:    Your book covers a wide array of topics, from treating patients in comas to living at home and returning to work. Once a survivor goes home, families become the primary caregivers and the only ones who see the survivor on a daily basis. How do you advise families to best prepare for this transition? 

FRASER:     I’d advise family members to tap their medical unit’s social worker for all the advisement and resources possible. The local brain injury association often has support groups and other educational sessions that can be very helpful. Some states have case management and resource care facilitators funded from DWI financial penalties and other sources. Your medical and local brain injury association staff will know about these opportunities if they do exist. The national Brain Injury Association’s web site has fact sheets, guides, and other resource links on almost all matters of concern for survivors and caregivers, as does TBI Model Systems. 

LASH:     The two signature wounds of the wars in Iraq and Afghanistan are traumatic brain injury and post traumatic stress disorder. Anticipating the influx of returning veterans, how do you think military and civilian service systems could collaborate to better serve the needs of the vets? 

FRASER:     The Department of Defense, Veterans Administration, and other veteran related nonprofits have a significant range of services as outlined in the Workbook’s chapter for veterans by Drs. O’Connor and Drebing. Unfortunately, as the veteran moves closer to community adjustment, the existing federal and state agencies often don’t coordinate. If the Veterans Administration does not provide direct job placement assistance, as an example, there should be a formal transition agreement to the state vocational rehabilitation agency. This presently doesn’t occur. 

Success in post-secondary education is also challenged for the veteran by lack of support. The VA and the state community and four-year colleges could share resources and personnel in staffing support sites to provide mentor-ship, study skills, peer-to-peer support, etc. Without intense support, veterans with TBI and PTSD are highly unlikely to sustain and progress in higher education. Presently, there are only pockets of these types of substantive and coordinated services around the country. Obviously, much needs to be done relative to community adjustment and stabilization.

One Response to “Interview with Dr. Robert Fraser”

  1. Susan Wahl says:

    D. Fraser addressed the very same issues I am dealing with, i.e., relationships, employment, and depression. Treatment for children who sustained severe TBIs in the 1960s, when I was injured, was limited to institutional care. It is a blessing that this has changed, but not quickly enough. Being a survivor or a caretaker (for short periods of times, I was both) is extremely challenging, and yes, the quality and quantity of care hangs heavily on federal and state accountability. The quality of care provided to veterans who have sustained TBI and PTSD has improved immensely, allowing the influx of survivors than in previous wars/conflicts. But labor departments cannot accommodate an increase of case management when states are cutting back on vocational rehabilitation agencies alone. On a separate note, however significant the American Disability Act has allegedly improved the potential employment of the disabled, I personally have not experienced it. I agree we are substantially behind in community adjustment and stabilization because of ineffective financial planning on several levels.

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