Trauma is a word commonly known and spoken by health care providers but often misunderstood in terms of range, depth, complexity, and implications to neurorehabilitation.
Trauma is a word commonly known and spoken by health care providers but often misunderstood in terms of range, depth, complexity, and implications to neurorehabilitation.
While we often assess for and are able to easily observe overt symptoms of trauma, such as anxiety, depression, isolation, and fear-based responses, the neurological and neuropsychological effects are more difficult to pinpoint. These effects often require a more diligent assessment. When individuals are exposed to trauma early in their lives, their brains undergo significant neuroarchitectural changes. This can include changes to white matter integrity, which is essential for efficient communication between different regions of our brains. Structural neurological changes are also possible. One example of this is an enlarged amygdala. This area of the brain is responsible for emotional processing, especially fear and anxiety.
These are just two examples of the many changes that can occur. These neurological alterations can lead to profound deficits in an individual’s perceptual and sensory networks. These deficits impair how they perceive and experience the world around them. These types of neurological changes can also significantly impair someone’s ability to self-reflect and cognitively discriminate between safety and threats. This can cause difficulty with self-regulation. These impairments also often lead to chronic heightened anxiety, aggression, risk-taking, substance abuse, and perceived impaired empathy. Individuals suffering from this often confront major social difficulties, which only heightens their psychological distress.
It is critical that treatment providers evaluate both pharmacological and non-pharmacological interventions to optimize rehabilitation outcomes. It is also important to understand the difference between Trauma-Informed Care and Trauma Responsive Care. Trauma-Informed Care gives providers awareness about what happened to someone in their past. Trauma-Responsive Care (TRC) helps providers goes beyond awareness. In TRC, providers utilize specific interventions and strategies tailored to the address the needs of individuals who have experienced either single event or chronic/multiple traumas. These tailored interventions can help achieve better and more durable outcomes. While some individuals may recognize their own behavioral patterns, most do not understand the underlying neurological etiology and how to compensate to improve their quality-of-life experiences. By using a TRC approach, providers are able to work with individuals to become active contributors in their own recovery.
Pritesh Parbhoo, Psy. D, is the Executive Director of NeuroRestorative Florida, Maine, and New Hampshire. He completed his clinical residency at the University of Texas Health Sciences Center in San Antonio followed by a post-doctoral neuropsychology fellowship at Comprehensive MedPsych Systems. Over the course of his clinical tenure, he served in various roles such as Clinical Director, Program Director, Area Director, and State Director. Dr. Parbhoo’s clinical expertise are in the areas of neuropsychological assessment and treatment of concussions,
brain injuries, strokes, spinal cord injuries, neurodegenerative disorders, and complex developmental disabilities and related neurobehavioral treatment. He is also a Certified Autism Spectrum Disorder Clinical Specialist. Dr. Parbhoo’s current focus is in program/business/leadership development and the implementation of evidence-based practices to optimize an individual’s outcomes. He has previously presented CEU-approved lectures for medical, legal, and legislative organizations, as well as expert witness testimony. Additionally, he has appeared as a commentator for ESPN and “In View” with Larry King and was a finalist for the Tampa Bay Business Journal’s 2013 Health Care Heroes Award.
