TBI VOCATIONAL CLASS LESSON PLAN Module 1

Transcription

TBI VOCATIONAL CLASS
LESSON PLAN
Module 1: Self Awareness
Class 1
Objective(s):
1: Social Interaction - Participants will build social skills and self-awareness [ice breaker
activity and discussion]. This lesson:
Facilitates group cohesiveness and relationship building
Develops active listening skills
Develops memory
2: Self-awareness skills - Participants will build self awareness skills. In this exercise,
participants will list descriptions of themselves (both positive and negative) [Sun Exercise].
Introduction: Introduction to Module 1 and class schedule.
Ice Breaker: Everyone writes three things about themselves on a piece of paper. Two of them
are the truth and one is made up. Each participant reads his/her three things and the group
guesses which statement is not true.
Review of Self-Awareness: Participants give their definition of self awareness. Instructor
discusses definition of self-awareness as described in lesson plan.
Discussion: (1) Natural changes in self-concept through the course of life; (2) changes in self
concept and self awareness as a result of Traumatic Brain Injury (physical changes, emotional
changes); (3) importance of self concept to insure a well balanced life and for future
employment.
Activity: Pass out “Sun Exercise” and class was asked to fill out characteristics and qualities
about themselves. Activity is collected at the end of class for review next class.
Review: Facilitator summarizes the class and asks the participants to think during the next few
days about their characteristics and qualities that they like about themselves and ones that they
would like to change. This topic will be discussed in the next class.
Module I: Self Awareness
Class 1
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Jack be Nimble
Adapted from University of Nebraska-Lincoln, http://tbi.unl.edu/savedTBI/memory/strategies.html
TBI Memory Strategies
Factors that Impact Memory
Factors That Can
Facilitate Memory
Factors That Can
Adversly Affect Memory
• Exercise
• Drugs and alcohol
• Proper Nutrition
• Stress and tension
• Proper Amounts of Sleep
• Medical conditions and prescription drugs
Adapted from University of Nebraska-Lincoln, http://tbi.unl.edu/savedTBI/memory/factors.html
Module 3: Memory
Factors that Impact Memory
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Home Practice Tasks
• While watching news segments, generate two key words to assist with recall of
information to discuss with family member or friend.
• Video or audiotape a segment of the news from radio or television and summarize
in writing what you remember. Then, review the tape and compare information to
check recall. After reading a section of a magazine article, newspaper, or book,
summarize the key points to yourself or a family member.
• At the end of the day, take ten minutes to recall and discuss your activities and
events of the day. Attempt to recall specific information such as the time you
completed a particular activity, the location of the activity, the people you were
with including unfamiliar people, problems you encountered, and any new
information you learned.
• Prepare for the next day by recalling tasks still needing completion, as well as
other responsibilities to be completed tomorrow.
• Recall your weekly lists of to-do's and compare to written list for accuracy.
• Recall current month's family and friends' birthdays and check your calendar for
accuracy.
• At the beginning of the week, recall and discuss three to five enjoyable or
educational activities you completed the previous week.
• At the end of the week, recall three to five people whom you talked to during
the week; to increase difficulty, attempt to recall the topic of discussion.
• Plan a date in the near future to send a letter or pay bills and attempt to
remember to complete the tasks without any external cues.
Adapted from University of Nebraska-Lincoln, http://tbi.unl.edu/savedTBI/memory/hometasks.html
Module 3: Memory
Home Practice Tasks
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Memory Inventory
About this Inventory. Many individuals experience memory difficulties following brain injury.
In fact, memory disorders are among the top three complaints of traumatic brain injury patients.
For many patients, memory disorders resolve spontaneously a few months later. But for many
others such memory disorders never resolve.
What is Memory. Memory is a complex system of electrochemical processes in the brain.
Memories are the result of changes in the nervous system produced by selective changes in brain
cells. We remember things that are important, and we forget those things that are unimportant.
This is not a willful process; the brain takes care of it automatically. If you get excited about
something you are more likely to remember it. The things that we remember most readily are
those things which threaten us and those things that promise rewards.
How Memory Works. A simply stated explanation of how memory works is provided above. It
describes how it works in the intact brain. Damage to the brain's memory centers produce
corresponding impairments in the brain's ability to remember. Following a brain injury you
might find that you can no longer remember how to perform simple things that you should have
learned in kindergarten.
Because memory impairments tend to be the most pronounced in the first few years after TBI
many survivors come to believe that nothing can be done. This can make us anxious and
actually exaggerate this particular difficulty. Anxiety over memory lapses can actually interfere
with your ability to remember. Under such circumstances, feelings of inadequacy, and shame
tend to overwhelm all other memories
Research has shown that memory skills can be supplemented, and even improved with the
right interventions and attitude. The following memory inventory will help you identify your
memory strengths and weaknesses. And, our Memory Strategies tool will help enhance your
memory skills.
Types of Memory. There are several distinct types of memory. Sensory-motor memory (or
procedural memory) allows us to remember such things as how to walk, and how to tie a
shoelace. Another type, called semantic memory, enables us to retain general knowledge.
Two additional types of memory come into play when we recall a past event: narrative or
episodic memory, which enables us to recall a personally experienced event; and script memory,
in which we repeatedly experience the same event, and the episodes merge to form a generalized
version. The individual episodes are forgotten unless they depart significantly from the script.
Memory of personal experiences, whether narrative or script, is reconstructive. That is, we do
not store our experiences and play them back like a tape recorder. Instead, we recreate the past
experience at the time of recall. This re-creation is based in part, on the original experience, but
is also affected by factors influencing us at the time of recall.
Module 3: Memory
Memory Inventory
Page 1 of 6
Memory Disorders. It has been said that we are our memories. The sense of self is dependent
on intact memories. Memory disorders might cause difficulties in remembering familiar faces
and places. Short term memory difficulties can rob a person of the pleasure of reading. Memory
difficulties can interfere with career educational and personal goals. Chronic memory disorders
are among the most common complaints of individuals with brain injuries.
The following questions on the Memory Inventory are about how you remember
information. This is a self-assessment tool. It is provided for individual, personal use. It can
help you track and measure your memory abilities. It can help you to identify your memory
strengths and weaknesses. It can empower you to become more precise in reporting memory
difficulties to your doctor. In other words, it can help you to know when you need help and
enable you to find the help you need - including self-help.
sources:
Lezak, Muriel, Ph.D., Neuropsychological Assessment, 2nd ed. Oxford, 1983
Judith Hooper, Judith & Teresi Dick, The 3-pound universe - The Brain: From the Chemistry of the Mind to the
New Frontiers of the Soul. Laurel, 1986
Adapted from National Institutes of Health; Traumatic Brain Injury; http://www.headinjury.com/surveymem.htm
Module 3: Memory
Memory Inventory
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Memory Inventory
1
Rate your memory in terms of the kinds of
problems you have?
2
a.
b.
c.
d.
e.
How is your memory compared to the way
it was...
one year ago?
five years ago?
ten years ago?
before brain injury?
after brain injury?
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
How often do the following present a
problem for you?
names
faces
appointments
where you put things (e.g. keys)
performing household chores
directions to places
phone numbers you've just checked
phone numbers you used frequently
keeping up correspondence
personal dates (e.g. birthdays)
words
3
Major
Moderate Minor
Problems
Problems
Problems
Much
Worse
Same
Much
Better
Always
Sometime
Never
going to the store and forgetting what you
wanted to buy
m. going into a room and forgetting what you
wanted
n. pay bills
o. social cues - (resulting in inappropriate
response)
p. thank those that have helped you
q. show empathy for others
l.
r.
s.
t.
beginning to do something and forgetting what
you were doing
losing the thread of thought in conversation
knowing whether you've already told someone
something
Module 3: Memory
Memory Inventory
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Memory Inventory
Always
Some
Never
Only Fair
Very
Good
As you are reading a novel, how often do
you have trouble remembering what you
have read...
4
a.
the opening chapters, once you have finished
the book.
b.
three or four chapters before the one you are
currently reading.
c.
the chapter before the one you are currently
reading.
d.
the paragraph just before the one you are
currently reading.
e.
the sentence before the one you are currently
reading
When you are reading a newspaper or
magazine, how often do you have trouble
remembering what you have read...
a.
in the opening paragraphs, once you have
finished the article
b.
three or four paragraphs before the one you are
currently reading
c.
the paragraph before the one you are currently
reading
d.
three or four sentences before the one you are
currently reading
e.
reading
5
6
a.
b.
c.
d.
e.
f.
g.
How well do you remember things that
occurred in the past if the event was:
ten minutes ago?
an hour ago?
yesterday?
last week?
last month?
before brain injury?
after brain injury?
Very
Bad
Module 3: Memory
Memory Inventory
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Memory Inventory
7
When you actually forget events listed
below, how serious a problem do you
consider this to be?
a. names
b. faces
c. appointments - business, medical
d. appointments to hang out with friends
e. where you put things (e.g. keys)
f. performing household chores
g. performing routine work assignments
h. performing routine school assignments
i. maintaining personal safety routines
j. directions to places
k. phone numbers you've just checked
l. phone numbers you used frequently
m. keeping up correspondence
n. pay bills
o. personal dates (e.g. birthdays)
p. thank those that have helped you
q. show empathy for others
r. social cues - (resulting in inappropriate
response)
s. words
t. things people tell you
u.
wanted to buy
v.
beginning to do something and forgetting
what you were doing
losing the thread of thought
w.
x.
Very
Serious
Somewhat
Serious
Does
Not
Not
Serious Occur
knowing whether you've already told
someone something
Module 3: Memory
Memory Inventory
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Memory Inventory
8
a.
b.
c.
d.
e.
f.
g.
h.
Always
Some
Never
How often do you use the following techniques
to remind yourself about things?
keep an appointment book
write yourself reminder notes
make lists of things to do
have people call you
make grocery lists
plan your daily schedule in advance
mental repetition
associations with other things
keep things you need to do in a prominent place
where you will notice them
j. self talk
k. reminder service - friends or professional service
l. alarm clock
m. kitchen timer
i.
Use Memory Strategies to enhance your memory
Adapted from National Institutes of Health; Traumatic Brain Injury; http://www.headinjury.com/surveymem.htm
Module 3: Memory
Memory Inventory
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Memory Processes
Information
Input
You must register the incoming information
first. If you are distracted (i.e., watching TV
while studying or anxiously worrying about
failing) you are less likely to get information into
your memory to begin with.
Retaining
Information
Information has to be filed and stored in
memory. Retention of information is maximized
when it is held in memory in an organized manner
and is attached to other meaningful information
already in your knowledge base.
Retrieving
Information
Memory can involve either recall of information
(e.g., response to essay questions) or recognition
of information (e.g., response to multiple choice
questions). It is often easier to recognize
information rather than recall information.
Adapted from University of Nebraska-Lincoln, http://tbi.unl.edu/savedTBI/memory/processes.html
Module 3: Memory
Memory Processes
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Memory Strategies
1.
Develop a routine and stick to it.
Advance planning can help reduce the risk of forgetting.
2.
Create a place for everything and store everything in its place.
3.
Get organized.
4.
Utilize a tote bag or backpack.
Plan ahead place things in the tote bag or backpack that you will need for the day's activities.
5.
Use a To-Do list.
6.
Use a Journal to keep track of important plans, impressions, ideas, and appointments.
7.
Use a planning calendar.
8.
Use a system of reminders.
9.
Use cross references.
10. Use highlighters, margin notes and tabs.
11. Use repetition.
12. Make notes and use tabs.
13. Focus on one thing at a time.
Understand that your sense of knowing might have become impaired by your head injury.
14. Learn to trust your instincts.
15. Live in the moment.
Adapted from: National Institutes of Health; Traumatic Brain Injury
http://www.headinjury.com/memorystrat.htm
Memory Strategies
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Types of Memory
•
The ability to immediately recall recent or new verbal
and visual information, (i.e., remembering what was
just said in conversation or read in a book).
•
The ability to remember new information after a time
period of about 30 minutes (i.e., Remembering the
name of someone introduced to you 30 minutes
ago).
•
The ability to remember information known
previously such as, general knowledge, information
specific to your area of expertise, and personal and
biographical information.
•
The ability to remember a previously aquired pattern
or process (i.e., brushing teeth, taking a shower,
making a bed).
•
The ability to remember information that will be
needed in the future. (i.e., remembering to call a
friend about a planned activity)
•
The ability to remember temporal events and the
spatial relationship between those events (i.e.,
remembering the first day of work or school).
Short Term
Recent
Long Term
Procedural
Prospective
Episodic
Adapted from University of Nebraska-Lincoln, http://tbi.unl.edu/savedTBI/memory/processes.html
Module 3: Memory
Types of Memory
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LESSON PLAN
Module 3: Memory
Class 2
Objective(s):
1: Participants will practice active listening
2: Participants will take notes.
Review: Memory Inventory (activity from last class).
Discussion: Memory strategies.
Activity: Active listening role play. The facilitator will role play with each participant to see if
he/she can demonstrate some or all of the active listening skills:
• Eye contact
• Attention to posture
• Elimination of distractors
• Clarification of understanding
Activity: Note Taking. Each participant will determine what form of note taking has worked
for them in the past or that they use correctly. Each participant will write his/her weekly
activities in his/her DayTimer/notebook.
Discussion: Discuss using abbreviations or cues and checking DayTimer/notebook on a regular
basis.
Module 3: Memory
Class 2
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LESSON PLAN
Module 3: Memory
Class 3
Objective(s):
1: Participants will take notes.
2: Participants will schedule activities.
Activity: Note Taking. Everyone shows their DayTimer or notebook. Everyone should have
the week’s appointments written. Working with a partner one-on-one, discuss which style of
note taking they are using and offer suggestions.
Activity: Scheduling Daily Activities. The facilitator passes out the Daily Activities worksheet.
Each participant will write his/her activities for yesterday and today hour-by-hour.
Module 3: Memory
Class 3
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SCHEDULING DAILY ACTIVITIES
ACTIVITY SHEET #1
__________
You ran out of clean underwear and shorts. Laundry facilities are in the
basement of your apartment building.
__________
You have an important meeting with your supervisor from 7:30 am to 8:30 am.
__________
Your sister’s birthday is tomorrow. You haven’t bought a gift yet. The mall
where you want to go closes at 9:00 pm.
__________
You need to deposit your paycheck in the bank. It closes at 2:00 pm.
__________
You just found out your rent has been raised $150.00. It’s time to go apartment
hunting.
__________
Pay your bills.
__________
You promised mom you’d go shopping with her to buy your sister’s gift.
__________
You promised your roommate that you’d clean the bathrooms.
Module 3: Memory
Scheduling Daily Activities; Activity Sheet #1
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LESSON PLAN
Module 3: Memory
Class 4
Objective(s):
1: Participants use repetition and rehearsal to improve memory skills.
Review: Review note taking and scheduling strategies. Check DayTimers.
Discussion: Discuss the use of tape recording as a strategy to improve memory. How would a
tape recorder help you on the job?
Activity: Each participant will record something that they he/she has to remember by the end of
the class. The facilitator asks the participant to recite what he/she was supposed to remember.
Discussion: Discuss the importance of using repetition and rehearsal. The facilitator and
individual participants should become acquainted with the number of repetitions required to
recall information.
Module 3: Memory
Class 4
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COGNITIVE AND MEMORY SRATEGIES
FUNCTIONAL USE OF REHEARSAL STRATEGIES III
FOLLOWING DIRECTIONS
Materials:
Paper, pencil or pens
Purpose:
1. To apply the strategy of rehearsal to everyday work activities.
2. To acquaint clients with the number of necessary rehearsals they require before they can
correctly follow through with instructions.
Instructions:
Give a series of instructions and ask each client to state them prior to carrying through. For
example, say, “write your name, age, and date of birth.” Each client rehearses the command out
loud before carrying it out. Determine how many restatements of the instructions are necessary
before the client can carry out the directions correctly. From that point, encourage the client to
rehearse directions at least that many times before attempting them.
Module 3: Memory
Functional Use of Rehearsal Strategies III
Following Directions
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ACTIVITY 7
USING DAYTIMERS TO REMEMBER APPOINTMENTS
Materials:
DayTimer, Pens/pencils
Instructions:
Each participant is given an appointment with the facilitator. Each person writes his/her
appointment in his/her DayTimer. If he/she looks in his/her DayTimer and remembers his/her
appointment, he/she is given a word that is part of a phrase. When all appointments are over, the
group meets to put the words together to form the phrase. Anyone who did not receive a word
(forgot his/her appointments) can not participate and the others must formulate the phrase
without the missing word(s).
Module 3: Memory
Activity 7
Using DayTimers to Remember Appointments
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ACTIVITY 4
MNEMONIC STRATEGY
Materials:
None
Instructions:
Each participant is asked to name the group members and/or his/her case manager, work
supervisor, etc. If a person is having difficulty, a mnemonic strategy can be used and written in
their DayTimer for future reference. Some members may require the first letter that the name
begins with in order to remember.
Module 3: Memory
Activity 4
Mnemonic Strategy
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LESSON PLAN
Module 3: Memory
Class 5
Objective(s):
1: Participants use chunking and grouping to improve memory skills.
Review: Check DayTimers.
Discussion: Discuss the use grouping as a strategy to improve memory.
Activity: Participants try to memorize a list of 10 grocery items. Then they group another list
and try to memorize the items. (See also Activity 4 and Activity 5.)
Round 1
Round 2
1
Eggs
1
Jam
2
Bacon
2
Bread
3
Shampoo
3
Peanut butter
4
Bread
4
Toothpaste
5
Paper towels
5
Deodorant
6
Toilet paper
6
Butter
7
Toothpaste
7
Cereal
8
Milk
8
Hairspray
9
Yogurt
9
Milk
10
Peanut butter
10
Eggs
Module 3: Memory
Class 5
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Jam
Bread
Peanut butter
Toothpaste
Butter
Deodorant
Cereal
Hairspray
Milk
Eggs
Module 3: Memory
Class 5
Activity 4
List: 10 Grocery Items
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Jam
Toilet paper
Bread
Peanut butter
Toothpaste
Butter
Cookies
Paper towels
Laundry detergent
Eggs
Deodorant
Cereal
Hairspray
Milk
Cat food
Ice cream
Bacon
Yogurt
Shampoo
Crackers
Module 3: Memory
Class 5
Activity 5
List: 20 Grocery Items
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COGNITION AND MEMORY STRATEGIES
FUNCTIONAL USE OF CHUNKING/GROUPING AS A
COMPENSATORY STRATEGY
ACTIVITY 4
Purpose:
Teach participants to categorize
Demonstrate how the use of categorization on a functional activity enhances memory
Materials:
•
•
•
2 different lists of 10 grocery items
2 different lists of 20 grocery items
blank paper and pencils
Instructions:
1. Participants will be given a list with 10 grocery items on it. They will be asked to
memorize the list after looking at it for two minutes. They will then be told to turn
over the paper and write out the list from memory. Any participants who have
difficulty writing legibly or writing quickly enough can record their responses on a
tape recorder or verbally to the facilitator. It is important that response time is not
delayed for too long of a duration. Participants will keep a tally of how they did.
2. The facilitator will then work with the participants to categorize a second list of
grocery items and then give them two minutes to memorize their categorized list.
They will then be told to turn over their papers and write out or record the new list.
Participants will compare their results with the previous exercise.
3. Go through Step 1 with a list of 20 items; then Step 2 with a different 20 item list that
has been categorized with the class.
Note: Do not spend too much time categorizing the list - this gives extra time to clients
to review and memorize the items.
Variations:
Combine categorization strategy with techniques to further enhance memory for lists of
20 items. Have the participants rehearse the items out loud.
Module 3: Memory
Chunking/Grouping Strategy
Activity 4: 10 Grocery Items
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COMPENSATION STRATEGY
ACTIVITY 5
Purpose:
Demonstrate how the strategy of grouping or chunking of items assists with memory on a
functional task
Materials:
• Bag with be different items. The items should be selected so that groupings of 4-5
items with stellar properties or functions can be identified by the clients.
• Paper and pencils
Examples:
• Things to write with: pen, pencil, magic marker, crayon.
• Medical items: aspirin, band aids, Tums, prescription bottle.
• Accessories: earring, ribbon, barrette, broach.
• Grooming articles: comb, brush, make-up, lipstick.
• Food: Life Savers, peppermint candy, Tic-tacs (breath mints), package of Oreo
cookies.
Instructions:
1. Instruct the participants that you have be items in your bag and after dumping out the
items on the table, you want them to look them over and try to remember as many
items as possible. Leave the items in view for two minutes. After removing the
items, ask the participants to write down (or tape record) what they remember.
2. Review what chunking and grouping are and give several examples of these
strategies.
3. Instruct the participants that you will again dump out the items, but that you want
them to group the items as they try to remember them. Give them two minutes to
look over the items. Ask them to identify the different kinds or groups of items and
then to list the individual items under the groups. Compare how they did on the first
trial with the second trial when they used the strategy of grouping.
Module 3: Memory
Chunking/Grouping Strategy
Activity 5: 20 Grocery Items
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LESSON PLAN
Module 3: Memory
Class 6
Objective(s):
Review: Review how grouping helped to remember grocery items.
Activity: Activity 3: Participants are given a list of items found in a department store and are to
group them by department.
Activity: Activity 4: Participants are given a list of department store departments and are to
write items that would be found in each.
Module 3: Memory
Class 6
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ACTIVITY 3
Materials:
1. Handouts with lists of 20 items found in a department store
2. Handout with lists of departments in a store on which participants will identify items
found in each
Instructions:
1. Participants are given a list of 20 items they could find in a department store and are
asked to identify the department in which each item could be found. For the first
trial, pair participants with partners to come up with the answers. For the second trial,
participants will work individually. Audio taping could be used as an alternative to
written assignments.
2. Participants are given a list of departments in a store and asked to list at least five
items they could locate in each department.
Variations:
1. Participants will be given a list of stores in the mall and another list of items they
want to purchase. They must locate the stores in which they can purchase the items on
the shopping list and a reason why they chose that store (best buy, only store with that
item, best quality, etc.).
2. Participants can be taken to a mall with a shopping list of items they must locate
there. However, they can only purchase one item per store so they use a variety of
possibilities.
Module 3: Memory
Class 6
Activity 3: Grouping Items by Store Department
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ACTIVITY 3
Below is a list of items that can be found in a department store. Identify the department
in which each item can be found.
Trial 1:
Allure perfume
12” frying pan
Girls size 3 dress shoes
Woman’s nightgown
Cordless telephone
Picture frame
Hanes pantyhose
Revlon lipstick
Jeans for a 6-year old boy
Gold watch
Blender
Little girl’s purse
Socks for an adult female
China (registered by your engaged cousin as a wedding gift)
Big screen TV
Dress for your mom
Sega Genesis video game
Man’s belt
Socks for a newborn baby
Manicure
Tune up for your car
Module 3: Memory
Class 6
Page 2 of 6
ACTIVITY 3
Below is a list of items that can be found in a department store. Identify the department
in which each item can be found.
Trial 2:
Food processor
Diamond tennis bracelet
Hair cut
Men’s sandals
Ladies’ Nike running shoes
Toaster
Sunday hat for a woman
Fake pearl necklace
Support bra
Suit for Dad
VCR
Neckties
Comforter with matching sheet set
Jogging suit for a 10-year-old boy
Pirelli tires
Hair dryer
Robe for Mom
Family portrait
Pay $15.00 on your charge account
Answering machine
Module 3: Memory
Class 6
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ACTIVITY 3
Module 3: Memory
Class 6
Page 4 of 6
ACTIVITY 3
Below is a list of departments that are found in a department store. List five items that
can be found in each department.
Appliances and Housewares:
1.
2.
3.
4.
5.
Men’s Apparel:
1.
2.
3.
4.
5.
Electronics:
1.
2.
3.
4.
5.
Accessories:
1.
2.
3.
4.
5.
Module 3: Memory
Class 6
Page 5 of 6
ACTIVITY 3
Cosmetics:
1.
2.
3.
4.
5.
Lingerie:
1.
2.
3.
4.
5.
Children’s Apparel:
1.
2.
3.
4.
5.
Ladies’ Apparel:
1.
2.
3.
4.
5.
Module 3: Memory
Class 6
Page 6 of 6
LESSON PLAN
Module 3: Memory
Class 7
Objective(s):
Review: Review how chunking and grouping helped to remember individual items.
Activity: Word-search: Simple Problem Solving.
Module 3: Memory
Class 7
Page 1 of 1
LESSON PLAN
Module 4: Anger Management/Conflict Resolution
Class 1
Objective(s):
1: Participants are introduced to Anger Management/Conflict Resolution module
Discussion:
1. Introduction to Anger Management/Conflict Resolution module
2. Discuss:
• The importance of being able to handle conflict in the workplace
• How tolerance for frustration or difficult people may change after a brain injury
3. Ask participants if they feel that they have a more difficult time handling conflict since their
injuries
Activity: Conflict resolution quiz (What Makes You Angry?)
Class 1
Page 1 of 1
CONFLICT RESOLUTION
QUIZ
WHAT MAKES YOU ANGRY?
1. After saving your paychecks for nine months, you’re finally able to get the big screen
TV you’ve always wanted. You get it home and it’s great with the high gloss finish
on the cabinet. Later that day your younger brother is wresting with a friend and they
knock over a lamp which scratches the finish on the cabinet. You would probably:
a. Scream like a crazed barbarian, drag your brother across the floor by his teeth, set
his TV on fire and dance around the burning wreckage. 20 pts
b. Say nothing, go in your room, crank up your stereo and plot your brother’s slow,
painful death. 10 pts
c. After walking around the block 20 times to cool off, you talk to your brother
about an agreement to fix the scratch. 5 pts
2. After weeks of searching, you found it the perfect pair of pants. They were
expensive, but to die for. When you go to work the next day, a person you hardly
know says, “Oh, I guess Goodwill had a sale this week.” Everyone in the area who
heard her starts laughing. If you had a choice, you would:
a. Rip the water fountain out of the wall and throw it at her. 20 pts
b. Run to your boss and say you’re sick. Go home, dress in black, read poems about
death and ask why the world must be so cruel. 10 pts
c. Let it slide - for the time being. Later, when you are both alone, let her know the
comment in front of others embarrassed you, and ask her to not make comments
about your clothes in the future. 5 pts
3. You friends take you to a very expensive restaurant. All week you have looked
forward to having the specialty of the house, Lobster Dinero. When the waiter
comes, he informs you that they are out of lobster. A few minutes later another
waiter serves a steaming lobster to the table next to you. Nine out of ten times you
would:
a. Grab the lobster, hit the waiter with it and scream, “No lobster? What’s this look
like, buddy?” Later, excuse yourself, go to the restroom and stop up their toilets
and flood the restaurant. 20 pts
b. Say nothing, eat what you ordered. When you leave, sneak back and steal the
waiter’s tip. 10 pts
c. Tell your waiter you’re upset that the guy next to you got a lobster and you were
told they were out. As if maybe he made a mistake. 5pts
Conflict Resolution Quiz: What Makes You Angry?
Page 1 of 2
4. You and a friend decide to visit your sister at college, a boring 5-hour trip. You take
your friend’s car because it has a great stereo. You offer to bring your tapes, but your
friend says not to worry; he'll be sure to bring some tapes you like. When you are 60
miles out of town, you find out he only brought one tape: The Village People. You
hate The Village People. Your friend knows you hate the Village People. When you
stop for lunch, you would:
a. Tackle your friend, put them in a stranglehold and make them sing “YMCA” at
the top of his lungs until he passes out. 20 pts
b. Say nothing - for the entire trip. 10 pts
c. Walk around for a few minutes and calm down. Talk to your friend about how
your feel and agree to listen to the radio for the rest of the trip. 5 pts
5. You are really busy with a project you are helping your boss with at home. Your
roommate pleads with you to help him prepare for a big dinner party. Your job is to
put the roast in the oven at 3:00 pm so he can get his hair cut for the party. As you
are about to put the roast in, a friend calls. You completely forget about the roast.
When your roommate comes in 20 minutes before the party, he realizes the roast was
not put in the oven and goes ballistic. Chances are you would:
a. Grab the roast, throw it out the window and scream, “Well, I guess it’s done now,
isn’t it?” 20 pts
b. Stand there and agree you are an irresponsible weasel. Later, whine to friends
about how they hate you and how they mistreated you. 10 pts
c. Call a time out, admit you messed up, go to the store and buy an already-cooked
roast with your own money. 5 pts
Conflict Resolution Quiz: What Makes You Angry?
Page 2 of 2
LESSON PLAN
Class 2
Objective(s):
1: Participants define the terms conflict and violence
Discussion:
1. Discuss the Conflict Resolution quiz (What Makes You Angry?)
2. Define the terms conflict and violence and introduce how conflict is part of our lives
Activity: Conflict quiz
Activity: Violence quiz
Handouts:
1. Conflict: Obstacle or Opportunity?
2. Managing Anger Within the Self
Class 2
Page 1 of 1
CONFLICT RESOLUTION
QUIZ 1 – CONFLICT
Instructions: Put a check in the box under the TRUE column if you feel the statement is true
and a check in the FALSE column if you feel the statement is false.
TRUE
FALSE
1
There will always be conflict
_____
_____
2
Conflict should be avoided if at all possible
_____
_____
3
Conflict destroys relationships
_____
_____
4
The best way to resolve a conflict is to just drop the whole
thing and forget about it
_____
_____
5
All conflicts eventually end up in violence
_____
_____
6
In every conflict, there is a winner and a loser
_____
_____
7
The conflict is resolved if most of the parties involved are
satisfied with the outcome
_____
_____
In most conflicts there is usually one person or group who
is the problem
_____
_____
One of the most important things in resolving a conflict is
figuring out who is right and who is wrong
_____
_____
It is easier to handle a conflict when you hide your feelings
_____
_____
8
9
10
Quiz 1 - Conflict
Page 1 of 1
CONFLICT RESOLUTION
QUIZ 1 – CONFLICT
KEY
1
2
3
4
5
6
7
8
9
10
There will always be conflict
TRUE
As long as there are two people on the planet there will be
conflict, but it doesn’t have to be a negative experience. It can
lead to positive change.
Conflict should be avoided if at all possible
FALSE
If conflict is avoided, the problem may not be resolved. This can
lead to resentment.
Conflict destroys relationships
FALSE
The inability to handle conflicts destroys relationships.
The best way to resolve a conflict is to just drop the whole
thing and forget about it
FALSE
Generally, conflicts won’t go away. The problem will still be
there.
All conflicts eventually end up in violence
FALSE
How we deal with conflict determines the outcome.
In every conflict, there is a winner and a loser
FALSE
The best resolution is a win/win. You should go into a conflict
with a partnership approach.
The conflict is resolved if most of the parties involved are
satisfied with the outcome
FALSE
If even one person is not satisfied with the conflict, it can re-ignite.
In most conflicts there is usually one person or group who
is the problem
FALSE
You have to separate the problem from the person. Attack the
problem, not the person.
One of the most important things in resolving a conflict is
figuring out who is right and who is wrong
FALSE
Perceptions differ. You need to allow for the other’s opinions.
It is easier to handle a conflict when you hide your feelings
FALSE
Communicating feelings in a non-threatening manner is healthy.
Quiz 1 - Conflict - KEY
Page 1 of 1
CONFLICT RESOLUTION
QUIZ 2 – VIOLENCE
TRUE
FALSE
1
Males are more violent than females
_____
_____
2
Violence is a natural instinct
_____
_____
3
Television may promote violent behavior in children
_____
_____
4
Name-calling and put-downs are forms of violence
_____
_____
5
Violence is a way of handling conflict
_____
_____
6
Men only hit women because they are angry
_____
_____
7
Racism is a form of violence
_____
_____
8
Violence is preventable
_____
_____
9
Violence usually leads to more violence
_____
_____
10
Using violence proves that you are tough
_____
_____
Quiz 2 - Violence
Page 1 of 1
COOL DOWNS & TIME-0UTS
We first heard the term “time-outs” from Dr. Anne galley who works in a veteran’s medical
center in Tacoma, Washington. Some people call them “cool downs” but the name isn’t as
importantly the practice. A time-out or cool down is simply a tool to use to prevent you from
doing or saying abusive things that you know you’ll regret later.
TOM:
“I would reach a point where no matter what I learned in the groups or what the
court said, I just didn’t care. I was going to do something and nothing could stop
me. A cool down is like preventative medicine. Before you ever get to that place
where you don’t care anymore, you leave. The situation won’t change because
you left it for a while, but how you deal with it may change totally.”
Steps to take:
1. Talk to your partner about cool downs right away. Let him/her know that sometimes
when you’re together it may be necessary for you to take a time-out or cool down in
order to relax. Let him/her know that when you come back, you will agree on a time
either later that day or the next day to discuss the issue again. She/he might want to do
the same thing.
2. Take a time-out or cool down every time you think your anger is starting to climb by
recognizing your physical and emotional cues and leave the situation, place or person.
3. Do not swear, raise your voice, threaten or use any intimidating behavior.
4. Go somewhere and try to relax and thick positively about yourself. Remind yourself of
what your goals are in the program. It may help to walk, jog or do deep breathing to get
some tension out. Do not drive, drink alcohol or use drugs.
5. When you come back, decide with your partner on a good time for discussion of the
issue. Maybe it is a good idea to talk it over with a third party present; someone you both
trust. Sometimes after a time-out you may both decide the issue wasn’t worth discussing
if the first place and you mutually decide to just drop it. If you decide to discuss the issue
and you recognized the cues occurring again - TAKE A TIME-OUT!
Cool Downs and Time-Outs
Page 1 of 1
MANAGING ANGER WITHIN THE SELF
I. Identify WHEN you are angry.
1. To not identify feelings of anger, you will:
a. stuff it leading to resentment and frustration ,
b. convert it into depression
c. transform it into a body symptom (headache, ulcer, heart attack
d. cause it to explode in socially unacceptable/damaging ways
2. What does anger feel like in your body?
a. where do you feel it first?
b. how is that feeling different from other emotional feelings?
c. does the feeling come on suddenly or slowly?
3. Disguises of anger. What are OTHER ways you indirectly express anger?
a. sarcasm, negative thinking, putting others down, manipulating
b. super-sweet, “don't make waves,” inability to accept anger
c. blaming, confronting, complaining, seeing the worst in others, defensive
d. accident-proneness, feelings of self-hatred, forgetfulness, being late consistently
e. over-protectiveness, gruesome worrying , over-concern and controlling others, “I’m so
disappointed in you”
f. sadness, depression, “pity party,” martyr, anger turned on
g. apathy, resigned, hopeless, “I don't care,”
h. “pain in the neck,” “can’t stomach it,” “you wear me out”
II. What are the consequences of your anger (expressed directly or indirectly)?
1. Direct outcomes (short-term consequences)
a. you get what you want by intimidating another
b. you obtain feelings of power, control and/or release
c. you hurt another or break something
d. you frighten others
e. you get a lot of attention even though may be negative
f. you may feel uncomfortable about your outburst, as it may not fit your self image
2. Indirect outcomes (short-term vs long-term consequences)
a. sarcasm - you get what you want vs. the other person hates you
b. putting others down - you get them to be quiet vs. they hate you
c. super-sweet - you get others to do what you want vs. they resent you
d. blaming - you get others to feel bad about themselves vs. they hate you
e. etc., etc., etc.
III. Specifically, what are you angry about?
1. Can you change it?
2. Can Rev not change it, no matter what you do?
3. How can you adapt to it, if you cannot change it?
4. Is there any way you can look at “it” in a different light?
Managing Anger within the Self
Page 1 of 2
IV. Assertiveness
1. “I statements”
a. When you…
b. I feel…
c. The consequences are…
d. I would prefer…
2. Honest feedback to give the other information
a. “I have some information. Would you like to have it?”
b. stay in emotional contact, warm, toward goal of better communication
Managing Anger within the Self
Page 2 of 2
Major Moderate Minor
Memory Inventory
Rate your memory in terms of the kinds of
problems you have?
How is your memory compared to
2
the way it was...
a. one year ago?
b. five years ago?
c. ten years ago?
d. before brain injury?
e. after brain injury?
s
Problems
None
s
1
3
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
p.
q.
r.
s.
t.
Much
Worse Same
How often do the following present a problem
for you?
Always
names
faces
appointments
words
wanted to buy
wanted
pay bills
social cues - (resulting in inappropriate responce)
thank those that have helped you
show empathy for others
you were doing
losing the thread of thought in conversation
something
Always
Much
Better
Some
Never
Some
Never
As you are reading a novel, how often do you
have trouble remembering what you have
4
read...
the opening chapters, once you have finished the
a. book.
three or four chapters before the one you are
b. currently reading.
the chapter before the one you are currently
c. reading.
the paragraph just before the one you are
d. currently reading.
e. reading
Always
Some
Never
When you are reading a newspaper or
magazine, how often do you have trouble
5
remembering what you have read...
in the opening paragraphs, once you have
a. finished the article
three or four paragraphs before the one you are
b. currently reading
the paragraph before the one you are currently
c. reading
three or four sentences before the one you are
d. currently reading
e. reading
How well do you remember things that
6
occurred in the past if the event was:
a. ten minutes ago?
b. an hour ago?
c. yesterday?
d. last week?
e. last month?
f. before brain injury?
g. after brain injury?
Very
Bad
Very
Only Fair Good
7
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.
n.
o.
p.
q.
r.
s.
t.
u.
v.
w.
x.
When you actually forget events listed below, Very Somewhat Not
Does
how serious a problem do you consider this to Serious Serious Serious Not Occ
names
faces
appointments - business, medical
appointments to hang out with friends
performing routine work assignments
performing routine school assignments
maintaining personal safety routines
pay bills
thank those that have helped you
show empathy for others
responce)
words
things people tell you
wanted to buy
you were doing
losing the thread of thought
something
Always
How often do you use the following techniques
to remind yourself about things?
8
a. keep an appointment book
b. write yourself reminder notes
c. make lists of things to do
d. have people call you
e. make grocery lists
f. plan your daily schedule in advance
g. mental repetition
h. associations with other things
Some
Never
i.
j.
k.
l.
m.
keep things you need to do in a prominent place
where you will notice them
self talk
reminder service - friends or professional service
alarm clock
kitchen timer
Use Memory Strategies to enhance your memory
Head Injury Hotline Memory Survey © Copyright 1998
MEMORY MATTERS: STRATEGIES FOR MANAGING EVERYDAY MEMORY PROBLEMS
NOW WHAT DID I
COME IN HERE FOR?
Strategies for Remembering What You’re Looking For
Walking into the kitchen, Wallace stopped dead in his tracks,
scratched his head, and wondered, “What the heck am I doing in
here?” Last he remembered, he was sitting in front of the TV. “This
is crazy,” he thought. I know I came in here for something, but for the
life of me, I can’t remember what it was.”
Wallace is in good company. Forgetting what you are looking for is
another common problem reported by persons who’ve had a brain
injury. What can be done to remedy this frustrating problem?
• Avoid trying to do too many things at once. It’s much easier
to forget or get confused when you are trying to do different
things at the same time.
• Repetition, Repetition, Repetition. Repeat the name of the object of your
search over and over until you find it.
• Write down what you’re looking for. Even just one word may be enough to
trigger your recall.

If paper isn’t handy, write on your arm or hand.

If a pen isn’t handy, “write” with you finger.
• Take something with you to remind you what you’re looking for. For example, if you’re looking for your checkbook, take the bill you intend to pay.
• “Retrace your steps.” For some, going back to the “scene of the crime” helps
them recall what they’re looking for.

Walk back to the last place you remember being. Look all around.

Try to form a picture in your mind of what you were doing. Were you
sitting or standing? Were you alone or with someone?

Pantomime or “act out” what you were doing (e.g., writing something
down, opening a drawer, leafing through a book).
THE NATIONAL RESOURCE CENTER FOR TRAUMATIC BRAIN INJURY
Wallace returned to the den and noticed his half-eaten bologna sandwich. Pickles, he thought to himself, smiling. As he returned to the
kitchen, Wallace repeated “Dill” over and over again until he got to the
fridge. Pickle jar in hand, Wallace strutted back into the den to, well,...
relish his victory.
MY ACTION PLAN FOR REMEMBERING WHAT I’M LOOKING FOR
I seem to have
the most trouble
remembering what
I’m looking for
when…
To help me
remember what
I’m looking for,
I will do this:
Next time I
forget what I
went searching
for I will do this:
I will check my plan
on this date to see
if it’s working. If not,
I’ll need to try
another plan.
Module 5: VOCATIONAL
Class 1: Discuss work History
Class 2 Discuss Work Interest
Class 3: Discuss Vocational Abilities and strengths
Class 4: Discuss job Search Tactics
Class5: Discuss Calling for an interview
Class 6: Job Applications
Class 7: Prepare for the Interview: Conduct Mock Interviews
Class 8: Mock Interview
Journal of Daily Experiences
The items on this page are designed to help you understand, track and monitor a variety of issues
surrounding brain injury. It is broken down into areas of daily functioning and feeling states.
Each section addresses specific issues and is followed by links to additional information and
resources.
YOU KNOW YOU NEED HELP WHEN...
The items on the foregoing Journal of Daily Experiences, represent many of the impairments
or difficulties that commonly follow brain injury. Individually, the effects of such impairments
may be quite subtle, but collectively, they can be quite devastating. The Journal of Daily
Experiences was designed to track and measure such impairments.
You know you need help when such impairments substantially interfere with your ability to
perform your normal daily activities. It is a good idea to keep your doctor advised of the
appearance of any of the signs and symptoms on this chart. This chart can help you identify
things that you want to change that are not especially troublesome. You should consult a doctor
regarding any and all items on that list that causes you to feel concern.
NOTE: The appearance of many of these signs and symptoms could signify the presence of
serious medical problems.
TIPS FOR LIVING WITH BRAIN INJURY
•
•
•
•
•
•
•
•
•
•
•
Avoid high stress activities several hours before bedtime.
Allow time for a gradual wake up in the morning
Analyze and accommodate your new learning style.
The brain is easily fatigued after brain injury.
Build rest breaks into daily activities
Create a graduated program of mental and physical exercises
Adjust your expectations.
Be patient
Slight changes in daily routines can be disorienting
Recovery from brain injury is typically a life-long process
The up and down cycles of energy and fatigue are frustrating and confusing.
Many head injury impairments resemble the normal, human limitations that we all experience
from time-to-time even with out a brain injury. What distinguishes brain injury impairments
from normal is: the degree and frequency of their appearance; the circumstances surrounding
their appearance; and their disabling characteristics.
Don't hesitate to call the Head Injury Hotline with additional questions and concerns at
206-621-8558.
Pg 1 of 5
Instructions: Read the list of feelings and behaviors. In the brackets provided fill in the number
that overall best describes how you felt today.
Fill in 0 = not present during the last 24 hours. 1 = minimal, present but did not interfere with
activities; 2 = mild, some interference with activities; 3 = moderate, greatly interfered with
activities; 4 = extreme, interfered with all activities.
In the blank next to each item describe what you did today, if anything, about that particular item
(exercises, heating pad, listened to music, telephoned someone, medication, time-out).
1
2
3
4
5
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
Feelings and Behavior
Altered consciousness
Aggression - verbal / physical
Agitation unable to settle down
Anger
Anxiety - vague fear, worry, anticipation of
doom
Aura or weird reverie - trance
Backache or pain
Busy (more than usual)
Depression / felt sad or blue
Difficulty concentrating
Difficulty falling asleep
Difficulty making decisions
Difficulty Reading
Difficulty communicating
Difficulty finding words
Difficulty understanding
Difficulty being understood
Diminished analytical skills
Diminished capacity for reality testing
Diminished initiation (starting things)
Diminished execution (doing things)
Dizziness or vertigo
Easily distracted
Eating more than usual
Excitable
Fatigue or tiredness
Feelings of observing self from afar
Feelings of dread
Feeling everything’s an effort
0
1
2
3
4
Action Good Poor
Taken Result Result
Pg 2 of 5
29
30
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
Feelings of well being
Feeling unsure of yourself
Food cravings (type)
Forgetfulness
Generalized body aches
Guilt feelings
Headache or pains
Hearing music that others don’t
Heart racing or pounding
Heartburn
Hot flashes or sudden feelings of warmth
Hostility
Impatience
Impulsiveness
Indigestion / upset stomach
Irritability
Joint pain or stiffness
Less desire to talk or move
Loneliness
Loss of appetite
Loss of conscience or fainting
Metallic taste in mouth
Muscle spasms or twitching
Muscle weakness
Nausea
Nervousness
Nightmares
Numbness and tingling
Neck pain
Out of control feelings
Pain or discomfort -- specify
Panic feelings
Poor night vision
Rapid mood changes
Raging behavior
Restlessness
Reduced food intake (ate less than usual)
Sensation of skin crawling
Sensation of weight gain
Sensitivity to cold
0
1
2
3
4
Action Good Poor
Taken Result Result
Pg 3 of 5
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
Sensitivity to touch
Sensitivity to noise or sounds
Sensitivity to light
Seizures
Sexual desire
Smelling odors or fragrances that others
don’t smell
Skin breakout / acne
Sleeping too much
Swelling of hands or feet
Tearfulness / crying spells
Tension
Tinnitus - ringing in ears
Unable to get going
Vague longing or yearning
Vision, blurred
Vision double
Vision, spots or floaters
Visual blind spots
Vomiting
Waking up during the night
Awoke too early
Weight loss
Worrisome thoughts
Anything else?
0
Did you take any medicines, vitamins,
No
minerals, or nutritional supplements today?
Did you contact a health professional today
No
for any reason?
Did you contact anyone else today about
No
your health (friend, neighbor, husband, etc.)?
1
2
3
4
Action Good Poor
Taken Result Result
Yes Record number(s) and amount(s):
Yes Type of Professional and Reason:
Yes Relationship and Reason:
NOTE: Consult a doctor regarding any items on this list that causes you to feel concern. The appearance
of many of these signs and symptoms could signify the presence of serious medical problems.
YOU KNOW YOU NEED HELP WHEN...
The items on the foregoing Journal of Daily Experiences, represents many of the impairments or
difficulties that commonly follow brain injury. Individually, the effects of such impairments may
be quite subtle, but collectively, they can be quite devastating. The Journal of Daily Experiences
was designed to track and measure such impairments.
Pg 4 of 5
You know you need help when such impairments substantially interfere with your ability to
perform your normal daily activities. It is a good idea to keep your doctor advised of the
appearance on any of the symptoms on this chart. This chart can help you identify things that
you want to change that are not especially troublesome. You should consult a doctor regarding
any and all items on that list that causes you to feel concern.
Conditions such as auras, altered consciousness, weird reveres, flashing lights in your head,
metallic taste in your mouth, smelling fragrances that others do not smell, or hearing music that
others do not hear, muscle spasms or twitching, feelings of disembodiment or observing yourself
from afar, vague longing or yearning, raging, crying or laughing for no apparent reason might
signify seizure activity. In such cases you might want to pursue a seizure assessment. Your
doctor and/or The National Epilepsy Foundation (http://www.headinjury.com/linksepil.htm) can
refer you to a center in your area where you can obtain such an assessment.
Anger, anxiety, and anxiousness, rapid mood swings, depression, feeling blue, fearful, guilt,
rapid mood swings, listlessness, paranoia, feelings of panic, irritability, and loneliness and other
such symptoms might signify psychological disorders. For such conditions you should first seek
a medical assessment; then choose a doctor with special training and interests in diagnosing and
treating psychological disorders that result from brain injury, see the Doctor Finder document
(also available online at http://www.headinjury.com/doctorfind.htm).
Difficulties concentrating, mental tracking, making decisions, executing or doing things,
initiating or starting things, along with diminished analytical skills, diminished capacity for
reality testing, attentional defects, etc., have to do with cognition or knowing and doing things.
Often such problems respond well to cognitive rehabilitation. Centers that specialize in
diagnosing and treating head injuries are good sources of cognitive rehabilitation. Visit the
Rehab Facilities page on headinjury.com (http://www.headinjury.com/rehabfacility.htm) for a
rehab center near you.
Difficulties communicating, stuttering, finding and expressing words, understanding and being
understood are the stuff of speech pathology. The National Aphasia Foundation can provide
information about such communications disorders. Conditions such as, blurred and/or double
vision, floaters, blind spots and visual neglect fall within the purview of opthometrics, or vision
specialists that treat vision difficulties caused by physical trauma, such as head injury. See
Vision Disorders on headinjury.com (http://www.headinjury.com/vision.htm).
Heart pounding, rapid pulse, shallow respiration, headache or pain, tinnitus or ringing in the ears,
nausea, vomiting, dizziness, might signify brain injury impairments they could also indicate
other medical conditions, and should be evaluated by a knowledgeable physician. Refer to the
Doctor Finder page on headinjury.com (http://www.headinjury.com/doctorfind.htm) for
guidelines on selecting and evaluating doctors and practitioners that treat these and other such
conditions. Also see Links to Programs, Support Groups and Resources section of the
headinjury.com library at http://www.headinjury.com/library.htm#support.
Adapted from: National Institutes of Health; Traumatic Brain Injury
http://www.headinjury.com/journal.html
Pg 5 of 5
Module 6: Time Management/Scheduling
Class1: Time Management Inventory
Class 2: Personal Time Management
Class 3: Scheduling
Attachments include:
Journal of Daily Experiences 1 and 2
TBI TODAY
Page 1
VOLUME 2 NUMBER 4
TBI TODAY
REPRINTED FROM VOLUME 2 # 1(WINTER 2003)
News, Ideas, and Resources from the Virginia TBI Model System
PART I: MANAGING STRESS EFFECTIVELY AFTER TBI
Brain injury causes sudden,
u nexp ec t ed, and dras t i c
changes in the lives of survivors
and family members. Learning to
effectively manage the stress
associated with these changes
may be one of the greatest challenges faced by family members
after brain injury.
What is stress? For most people, stress is that uncomfortable
feeling you get when you know
there is something you should
be doing and you’re not doing it.
Stress is often a “vicious circle.”
The more a person feels they
have to do and the more that
people are telling them what to
do – the more stress they feel.
People also feel more stress if
they worry about failure.
Think of stress as like
“carrying a stuffed backpack up
a big mountain.” Climbing the
first hundred feet, your pack may
not seem heavy at all. Though
nothing gets added to the pack
as you go, the weight seems
heavier and heavier as you keep
climbing without resting. If you’re
not careful, the bag gets so
heavy you can’t walk any more.
Seriously, intense stress, over
time, can have disastrous effects
on your health.
Stress is a part of daily life.
With or without being touched by
brain injury, everyone will face
stress at some point in their life.
Through interviews and surveys,
researchers have learned a lot
about stress by studying people’s everyday lives. Below is a
list of life events that surveys
show are rated most stressful.
Can you guess the “top five”?
Circle your guesses (See page 2
for survey results)
Spouse's retirement
Single parenting
Moving
Spouse’s illness
Change in financial
state
Child’s illness
Depression
Raising teens
Parenting parents
Child returning home
Marital separation
Fired at work
Chemical dependency
On page 6 is a list of things
that we’ve heard from survivors
and family members. Do any
sound like you or someone you
know?
Ñ My mother’s been afraid to
leave my father at home
since his injury. Sometimes
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my mom asks me to watch
him when she goes out.
Ñ My brother’s drinking problem got a lot worse after his
injury. Now he drinks every
day.
Ñ To help with finances, we
sold our house and moved to
an apartment.
Ñ My son was living in a dorm
at school before the injury.
He lives with us again and
we’re not sure when he’ll go
back to school.
Ñ We were married for nine
years before the injury.
Three years after he got hurt,
we separated. He’s living in
an apartment and I’m living
in our home.
Ñ Since my wife’s injury, I am
basically raising our 4 and 5
year old girls by myself. She
really can’t handle them
alone.
Ñ Frank and I were arguing all
the time since the accident. I
had to move in with my sister
because I couldn’t take it
anymore.
Ñ My husband was fired from
his job. He prefers to call it
“retirement.”
The effects of stress can be
sneaky. You may not even notice at first, or you may chalk up
the problems to something else.
Let’s look at how your life might
(Continued on page 2)
TBI TODAY
Page 2
VOLUME 2 NUMBER 1
statements that are true about you or “F” for statements that are not true on the 13 Item Stress Test.
Be honest, now. Nobody’s grading this thing but
you.
Pencils down! Well? What’s the verdict? If you
answered all F’s then you’re stress free or maybe
fooling yourself. The more T’s you circle, the
greater your level of stress and the more you need
to think about taking steps to change. Here are
some ideas to help you better deal with stress. Try
them out and use the ones that work best for you.
Think, talk to other people, and try to come up with
more ideas.
(Continued from page 1)
be affected by stress:
Stress Overload Signs
` Disorganization (forgetting your keys, losing
things, making a lot of “dumb mistakes”)
` Daydreaming about spending a few days
somewhere, even in the hospital - to sleep,
read, be taken care of
` Trouble making even small decisions
(having difficulty figuring out what to wear,
feeling stumped about what to have for
lunch)
` Feeling depressed (wanting to curl up on a
bed, pull the covers up over your head, and
sleep for a week)
Still not so sure whether you need to worry about
stress? We’ve come up with a brief questionnaire
that can help you identify your levels of stress. Get
that pencil back out again and circle the “T” for
; Check your “pressure gauge” often.
; Practice effective problem solving. Brainstorm
ways to solve problems and try out different solutions.
; Have a back up plan.
; Take time for yourself, do things you enjoy
; Tell yourself to relax, breathe slowly and
deeply.
The 13-Item Stress Test
I have a lot to do.
T
F
I have more to do than I can handle.
T
F
I’m not being productive.
T
F
I’m trying really hard but getting nothing
done.
T
F
I’m feeling unhealthy.
T
F
I can’t afford to take breaks or time off.
T
F
I’m pushing myself too hard.
T
F
I don’t sleep very well.
T
F
MOST STRESSFUL SITUATIONS
Too many people are telling me what to
do.
T
F
The following life events/situations are in ordered from the most
stressful (# 1 ) to less stressful (#13)
I am not treating people the way I want to
be treated.
T
F
I feel totally exhausted.
T
F
Nobody is happy with what I do.
T
F
I can’t stand living like this.
T
F
; Seek support from trusted friends and family.
; Close your eyes, imagine yourself in a pleasant
situation or place.
; Keep up a healthy lifestyle - exercise, eat right,
avoid caffeine, alcohol, drugs, and tobacco.
; Talk to others about how they cope successfully.
In the next issue of TBI Today, we’ll have even
more practical ideas on handling stress better.
By Debbie West & Jeff Kreutzer
1.
2.
3.
4.
5.
6.
7.
Single parenting
Depression
Child’s illness
Spouse’s illness
Fired at work
Marital separation
Spouse's retirement
8.
9.
10.
11.
12.
13.
Parenting parents
Raising teens
Chemical dependency
Moving
Child returning home
Change in financial state
With permission of the authors, this article has been reprinted from the Winter 2003 issue of TBI Today, published by Virginia Commonwealth University’s Department of Physical Medicine and Rehabilitation’s Neuropsychology Service. This newsletter, is a project of the
Virginia Model System, which is funded by the US Department of Education's National Institute on Disability and Rehabilitation Research (NIDRR). The views, opinions, and information presented herein are those of the publisher and are not necessarily endorsed by
the US Dept of Education.
TBI TODAY
REPRINTED FROM VOLUME 2 # 2 (SPRING 2004)
News, Ideas, and Resources from the Virginia TBI Model System
MANAGING STRESS EFFECTIVELY AFTER TBI, PART II
In our last issue, we wrote about
stress and the effects of stress on
our daily lives. You may recall
that we gave some signs of
“stress overload”:
` Disorganization (forgetting
your keys, losing things,
making a lot of “dumb mistakes”)
` Daydreaming about spend-
ing a few days somewhere, even in the hospital - to sleep, read, be
taken care of
` Trouble making even small
decisions (having difficulty
figuring out what to wear,
feeling
stumped about
what to have for lunch)
` Feeling depressed (wanting
to curl up on a bed, pull the
covers up over your head,
and sleep for a week
selves enough rest
, Realize that working
harder doesn’t necessarily
mean accomplishing more;
instead, recognize that taking breaks can help you
accomplish more and feel
better
, Avoid the cycle of going
beyond your limits, spinning your wheels, and becoming frustrated
, Take several 20 – 30 min-
ute breaks each day, take
more time if needed
, If you can’t spare 20 min-
utes take 10, a short break
is better than no break
, If you are working, make
your home a more comfortable place by leaving your
work at work
MAKE A LIST
What do you do if you feel
overloaded with stress? Here are
some ideas to help you cope with
stress. Review the list and try out
some of the ideas.
TAKE BREAKS OFTEN
, Famous last words, “I can’t
take a break. People will
think I’m lazy and that I
don’t care.”
, Realize that most family
members don’t give them-
List what you need to do in
the short- and long-term,
and set priorities - number
items by priority
Start with number 1 and
work your way down the
list, crossing off each accomplished item
Regularly review your accomplishments to help you
keep a positive perspective
Realize that you can only
do one or maybe two
things at a time effectively
Remember that “good”
things can also be stressful; planning and having a
birthday party, preparing to
visit and visiting other family members
Don’t forget activities re-
lated to helping yourself (e.
g., getting rest, spending
time with other family
members) can also be important priorities
Learn and recognize the
difference between what
you “have to” do and “want
to” do
SET REASONABLE GOALS
AND EXPECTATIONS
Learn to recognize what
you do best
Recognize your limitations,
most relate to being human
Avoid letting people pres-
sure you into taking on
more than you can handle
Recognize what others do
best and ask for their help
If you keep missing dead-
lines, be less ambitious
Distinguish between what
you want and expect and
With permission of the authors, this article has been reprinted from the Winter 2003 issue of TBI Today, published by Virginia Commonwealth University’s Department of Physical Medicine and Rehabilitation’s Neuropsychology Service. This newsletter, is a project
of the Virginia Model System, which is funded by the US Department of Education's National Institute on Disability and Rehabilitation
Research (NIDRR). The views, opinions, and information presented herein are those of the publisher and are not necessarily endorsed by the US Dept. of Education.
what other people want and
expect from you
Recognize and avoid harm-
TELL YOURSELF THINGS
THAT WILL HELP
Ñ I’m doing the best that I can
ful feelings like guilt and
frustration
Ñ I’m a good person, I’m try-
LEARN AND APPLY
NEGOTIATION SKILLS
Ñ If I take my time I’ll do
ing
A Realize that few of your re-
sponsibilities are “set in
stone,” and most people
who expect you to do
things are willing to negotiate
A With other family members
and co-workers, negotiate
timelines and the amount of
responsibilities you agree
to take on
A If you are afraid of negotiat-
ing, practice by rehearsing
“in your head”
A Realize that taking on too
things right
Ñ Things will work out for the
best
Ñ We’ve really come a long
way since he was hurt
Ñ I can count on faith, my
friends, and family to help
me through
AVOID PUSHING
YOURSELF TOO HARD
OR PUTTING
YOURSELF DOWN
: I’ve got to do more
: I’ve got to try harder
: I’ve got to get this done
much too soon will cause
failure
right away
A Balance wanting to please
with your knowledge of
what you must do to succeed
: I should have finished a
: I’ll never get another
chance
: I can’t believe I’m doing so
ine yourself in a relaxing
situation
Listen to soothing music
Take a walk
Talk to someone you like
COMMON SENSE
STRATEGIES CAN
HELP YOU BE STRONG
h Focus on one thing at a
time
h Work on your hardest re-
sponsibilities at times when
you feel most fresh and
rested
h Have “quiet times” for eve-
ryone, noise can increase
stress and reduce productivity
HAVE A BACK UP PLAN
Failing and not knowing
what to do next is a bad
situation
Any time you plan some-
thing, have a back-up plan
Recognize your human im-
perfections, most people
fail sometimes
When your first approach
doesn’t work, go to your
back-up
RECOGNIZE THAT LIFE
HAS MANY CHALLENGES
` Brain injury or not, many
bad
Breathe slowly and deeply
Close your eyes and imag-
right before you fail
week ago
: I’m letting everyone down
LEARN AND USE
RELAXATION TECHNIQUES
K Better to ask early on than
ASK FOR HELP
K Seek help from people that
have offered
K Recognize that asking for
help is better than failing
K Don’t let your pride get in
the way
K Recognize that everyone
needs help sometimes
people struggle to enjoy
successful lives
` Recognize that many of the
issues you face are faced
by others
` Be patient, everyone finds
obstacles on the road to
success
` Recognize that persis-
tence, faith, and your good
character will help you to
succeed in time
IMAGINE…TBI TODAY AVAILABLE ON-LINE!
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and get the latest information and findings from the TBIMS mailed directly to your computer.
Contact TBI Today editor, Debbie West, at ddwest@vcu.edu (804-828-8797) for information.
Module 7: Health/Wellness and Nutrition
Class1: Exercise
Class 2: Fatigue
Class 3: Nutrition – The Food Pyramid
Class 4: Nutrition – Food Labels and Dietary Guidelines
Attachments: Dietary Guidelines 1 and 2
Managing Stress 1 and 2