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.

The Australian community is ageing; over the next 40 years, our population over the age of 65 years will double to around 23%, and this considerable increase in older adults means an increasing number of people will be at risk of sustaining trauma through falls or road traffic accidents. In contrast to the increasingly well-documented outcome literature on younger adults, very few studies have focused on older adults. Instead of assuming that outcomes posttraumatic brain injury (post-TBI) will follow similar patterns as in younger samples, there are several reasons to investigate older age recovery separately, and these issues will be discussed by reviewing some of the primary characteristics of older adults who experience traumatic brain injury.

Stroke is a preventable disease leading to physical, cognitive and emotional disability. Its high prevalence and poor outcome shifts this disease from the clinical, medical realm to a significant public health problem. This article provides an overview of the problem, and the status of stroke prevention in the Australian context. To achieve this, it first examines the recent Australian surveillance data on stroke, identifying the at-risk groups. It then argues for targeted stroke prevention, assesses relevant policies and programs in the international and Australian contexts, and briefly reviews approaches for increased awareness and recognition of stroke symptoms. The article concludes by emphasising the need to account for the at-risk-groups when developing targeted health promotion campaigns for effective prevention of stroke in Australia.

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.

The cognitive symptoms that characterise the Wernicke-Korsakoff's syndrome include anterograde amnesia, confabulation, temporal–spatial disorientation, severe apathy, poor awareness of one's own mental state and changes in executive functions. Such deficits may persist even after the clinical profile stabilises. There are no studies that report an intervention after the acute phase, possibly due to the complexity of these cases. This study provides a descriptive analysis of neuropsychological rehabilitation concomitant to the neurological and psychiatric treatment of a woman who presented the symptoms described by Korsakoff. The intervention focused on reducing the impact caused by the cognitive and behavioural sequelae in the patient's daily life. It described a 25-week neuropsychological program, providing education and compensatory strategies for the patient, and also orientation and support from 2 professional caregivers and family members. Quantitative and qualitative measures were used to evaluate the effect of the intervention on memory efficacy, emotional state and social participation. Both caregivers reported a decrease in the frequency of memory lapses after treatment. Positive changes were also seen in self-care, activities at home, decision-making and participation in social activities. It is concluded that this case achieved results through the collaboration between members of an interdisciplinary team and caregivers providing daily support.

Introduction: Frontotemporal dementia (FTD) is a progressive neurode-generative brain disease characterised clinically by abnormalities in behaviour, cognition and language. Two subgroups, behavioural-variant FTD (bvFTD) and semantic dementia (SD), also show impaired emotion recognition particularly for negative emotions. This deficit has been demonstrated using visual stimuli such as facial expressions. Whether recognition of emotions conveyed through other modalities — for example, music — is also impaired has not been investigated. Methods: Patients with bvFTD, SD and Alzheimer's disease (AD), as well as healthy age-matched controls, labeled tunes according to the emotion conveyed (happy, sad, peaceful or scary). In addition, each tune was also rated along two orthogonal emotional dimensions: valence (pleasant/unpleasant) and arousal (stimulating/relaxing). Participants also undertook a facial emotion recognition test and other cognitive tests. Integrity of basic music detection (tone, tempo) was also examined. Results: Patient groups were matched for disease severity. Overall, patients did not differ from controls with regard to basic music processing or for the recognition of facial expressions. Ratings of valence and arousal were similar across groups. In contrast, SD patients were selectively impaired at recognising music conveying negative emotions (sad and scary). Patients with bvFTD did not differ from controls. Conclusion: Recognition of emotions in music appears to be selectively affected in some FTD subgroups more than others, a disturbance of emotion detection which appears to be modality specific. This finding suggests dissociation in the neural networks necessary for the processing of emotions depending on modality.

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.