Chris suffered a traumatic brain injury after falling down a flight of stairs. He was admitted to an acute hospital ward for four months before being admitted to West Heath House.

After having his initial assessment by the Clinical Team at West Heath House, Chris received on going input from clinical psychologists, occupational therapists and physiotherapists on a regular basis throughout the duration of his stay.

At the point of admission his aggressive behaviour was being managed through the prescription of anti-psychotic medication and had one to one support whilst on the acute hospital ward. Chris’ limited awareness of the impairments resulting from his brain injury was one of the most significant barriers to his successful rehabilitation, as discussion of these difficulties often acted as a trigger for aggression. One of the main areas of intervention was therefore finding effective ways of engaging him in a nonthreatening way so that he was able to maximise his participation in meaningful activity.

Chris’s aggression was reduced significantly through the introduction of regular access to structured activities developed collaboratively with him at his desired level. Doing this enabled him to develop a level of trust with the staff, making him less likely to experience anxiety through social interaction. He was supported to use his room as a place of safety to withdraw to as a way of avoiding exposure to triggers that might make him aggressive towards other people.

During his rehabilitation these behavioural management strategies meant that the medication prescribed to manage his mood and aggressive behaviour could gradually be withdrawn. At the point of discharge Chris no longer required any psychoactive medication.

Just before discharge, Chris required the support of only one member of staff when accessing the community. His physical fitness and balance improved as a result of an increase in community activities. Furthermore, the support provided a significant increase in opportunities for social participation.