Ballymena, Northern Ireland
DR ROSEMARY MACARTNEY
BSc(Hons) DPhil DClinPsych CPsychol AFBPsS HCPC Registered
Mild Traumatic Brain Injury (MTBI) or Post concussion syndrome
Post concussion symptoms are caused by a blow to the head (e.g. a sports injury, fall or other event) that has not caused permanent damage to the brain. There may be no loss of consciousness and brain scans may be clear. This is known as a Mild Traumatic Brain Injury (MTBI) (those within the medical profession my use the term 'post concussion syndrome') and such an injury should not lead to permanent deficits.
Most people who suffer an MTBI find that symptoms resolve within a few weeks or months. If the MTBI symptoms do not resolve spontaneously there may be development of secondary psychological symptoms that mask the underlying problem. Well-meaning treatment such as medicine to relive anxiety or depressed mood may not be successful and may even cause the symptoms to worsen.
The symptoms can affect a person's everyday functioning and can be very distressing.
Early education on management of MTBI can allow the symptoms to resolve and prevent their misinterpretation. Generally only short intervention is necessary and. if treated early, one assessment and advice session may be sufficient.
Dr Rosemary Macartney has many years of experience working in this area having developed and run the first Mild Traumatic Brain Injury Service in Northern Ireland and one of the first in the UK. The therapies that have been developed have been shown to remove or reduce symptoms and in the majority of cases to allow the individual to return to their pre-injury activities.
Therapy and management
When the neuropsychological assessment is completed, the information must be correctly interpreted before providing feedback both verbally and in written form. The assessment results should clarify what areas of brain function are intact and what areas have suffered damage/decline. The results should also clarify what effects the changes to brain function are likely to have on behavioural and emotional control.
Advice is given on how to manage any difficulties. A range of therapeutic approaches may be taken to help improve certain areas of cognitive function. In addition strategies may be put in place to help compensate for cognitive deficits.
Emotional change can be common and difficult to understand. It can cause considerable difficulties within relationships. Neuropsychological assessment can inform as to whether the changes are caused by damage to the brain or are the psychological consequences of an accident or illness.
A range of psychotherapeutic techniques are available to help deal with emotional change. With the person's permission, it may be helpful to include a spouse/family member or significant other in the therapy process.
The amount of therapy that is provided is agreed with the person beforehand and is tailed off as she/he becomes able to manage his/her symptoms.
An acquired brain injury (ABI), stroke or other illness affecting the brain's function can lead to difficulties with a person's thinking and with controlling behaviour. Common areas of cognitive function that are affected include the speed that the brain processes information, the ability to maintain attention, and memory for things seen or heard. There may also be difficulties with planning and organising activities. Some may experience emotional problems and changes to the way they interact with others.
Neuropsychological assessment is used to establish the areas of brain function that have been damaged and the resulting effects this is likely to have on the person's work, family and social life.
It involves gathering a detailed history from the affected person. Sometimes a spouse, close family member or friend will be asked to be present to confirm or add information as memory loss or poor awareness can greatly affect the person's knowledge of his difficulties. Time is then spent carrying out a number of standardised psychometric tests. The process can be lengthy although a shorter screening assessment can sometimes provide sufficient information.
The tests are largely desk-based and are selected on the basis of the person's age and ability.
It is important that the test results are handled with care and a high degree of expertise is required to accurately interpret the findings.
After scoring and interpretation of the results a report is prepared and shared with the person and family member/spouse where appropriate. Further input in the form of education, advice, rehabilitation or management techniques are then provided depending on need and the wishes of the person involved.
Legal reports for court purposes are prepared for the requesting solicitor. Reports regarding capacity are also provided for health professionals to aid decisions regarding placement or care.
After years of experience Dr Rosemary Macartney has developed approaches to allow the assessment of even those with severely compromised communication and/or physical deficits to allow the establishment of the person's level of cognitive function.
Behaviour and Personality Changes
Often an acquired brain injury, stroke or other illness affecting the brain will lead to changes in a person's behaviour. Family and friends may see this as a change in personality. Not all these changes are distressing or difficult to live with, but it can be helpful to better understand this behavioural change.
In other cases the changes in behaviour can be distressing and cause problems at home or in the workplace. For example there may be emotional issues or difficulty with control over what is said at home or at work. Such changes can cause difficulties for relationships at home or at work. It is very important that the reason for the behavioural changes is understood in order to tailor treatment and advice to meet your needs.
Neuropsychological assessment can tease out the reason for such changes to behaviour.
Some behavioural or personality changes are a direct result of damage to the brain's structures while others are caused by a psychological response to the life changes brought about by the injury or illness.
A neuro-behavioural approach may be used to reduce behavioural problems. Behaviour management techniques can be taught to the individual or to a spouse, family member or significant other to help manage the situation. Talking therapy can also prove valuable when relationships are affected. These approaches can significantly improve family life and help to restore relationships in the workplace or social settings.
Dr Rosemary Macartney has many years of experience working in the area of behaviour and emotional management and has achieved a research doctorate in behavioural change and learning techniques.
Requesting to be seen:
Contact can be made by email, telephone, or using the "Send a message" facility on the contact page.
Self referrals or referral through a health professional are accepted. Referral by a family member must have the person’s permission.
Legal Neuropsychological Assessment:
Neuropsychological assessment for legal purposes can be carried out at the request of a solicitor. Assessment for medical insurance claims can also be provided at the request of the insurance company providing cover.
If suitable for the Service an appointment will be provided.
Payment is by cheque or cash at the end of each appointment session. Details of fees will be provided when you are accepted for the service.