Brain Injury and Gender Role Strain Rebuilding Adult

Lifestyles After Injury, 1st Edition

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 More pre-publication
REVIEWS, COMMENTARIES, EVALUATIONS. . .
m ore engaged lifestyle (including ( t r ittle attention has been de-
man-sized helpings of male-identi­ - L t voted to the developm ent
fied social activities, caring male of intervention strategies for use
m entorship, and work experi­ with individuals with traumatic
ences) can m ake for a m ore re­ brain injury (TBT) in the post­
warding existence and the resum p­ acute period of recovery. Dr. Gut­
tion of a trajectory of adult devel­ man has developed an innovative
opm ent am ong m en with brain in­ target setting and treatm ent plan­
jury. Gutm an’s sensitivity to the in­ ning protocol that focuses the
dividual differences am ong these therapist on the key areas of co n ­
four men, as well as the com monal­ cern for individuals in the post­
ities of their experience as a result acute period of recovery from
of their disability, opens new ave­ TBI.
nues of perception.” Many individuals are injured
during the transition from adoles­
G elya F ra n k , PhD cent roles to mature adult roles.
Author of Venus on Wheels: Two Goals, activities, and rites of pas­
Decades o f Dialogue on Disability, sage are therefore missed by
Biography, and Being Female these individuals. Long cherished
in America goals suddenly appear unavail­
able. Activities that might appear
im portant to therapists are
stripped of their meaning for the
client leading to lack o f motiva­
tion and resistance.
Through extensive quotations
the reader gets to understand the
circumstances and concerns of
each client. Dr. Gutm an’s work
encourages therapists to set their
rehabilitative interventions in the
context of the developm ent of
meaningful life structures for per­
sons with TBI. The detailed pre­
sentation of four individuals dem ­
onstrates how the concept of
chronic role strain assisted the
therapist to form goals and treat­
ment interventions. Through this
More pre-publication
REVIEWS, COMMENTARIES, EVALUATIONS.
process, the client could fully en ­
gage in the tasks and derive
meaning from the activities and
the resulting outcomes. I highly
recom m end this book to thera­
pists w ho work with clients in the
post-acute period of recovery
from TBI.”

G o rd o n M uir G iles, MA,

D ip COT, OTR
Director
o f NeurobeharioraI Services
Crest'wood Behavioral Health, Inc.
and Assistant Professor
Samuel Menitt College
Oakland, C'A

T he H aw orth Press, Inc.

Thi s pag e intentionally left blank
 Brain Injury
and Gender Role Strain:
Rebuilding Adult Lifestyles
After Injury

Brain Injury and Gender Role Strain: Rebuilding Adult Lifestyles

After Injury has been co-published simultaneously as Occupational
Therapy in Mental Health, Volume 15, Numbers 3/4 2000.
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Brain Injury and Gender Role Strain: Rebuilding A dult Lifestyles A fter Injury, by Sharon A. Gutman,
PhD. OTR (Vol. 15, No. 3/4, 2000). "Dr Gutman has developed an innovative target setting and
treatment planning protocol that focuses the therapist on the key areas o f concern. I highly recommend
this book to therapists who work with clients in the post-acute period o f recovery’from TBI. ” (Gordon
Muir Giles, MA, Dip COT, OTR, Director o f Neurobehavioral Services, Crestwood Behavioral Health,
Inc., and Assistant Professor, Samuel Merritt College, Oakland', California)
New Frontiers in Psychosocial Occupational Therapy, edited by Anne Hiller Scott, PhD, OTR, FAOTA
(Vol. 14. No. 1/2,1998). “Speaks a clear message about mental health practice in occupational
therapy, shattering old visions o f practice to insights about empowerment and advocacy. ” (Sharan L.
Schwa rtzberg, EdD, OTR, FAOTA, Professor and Chair, Boston School o f Occupational Therapy, Tufts
University)
Evaluation and Treatment o f the Psychogeriatric Patient, edited by Diane Gibson, MS, OTR (Vol. 10,
No. 3, 1991). “Occupational therapists everywhere, learners and sophisticates alike, and in-hospital
and out-patient areas as well as home-bound and home-active, would enjoy and profit from this
exposition as much as I did. ” (American Association o f Psychiatric Administrators)
Student Recruitment in Psychosocial Occupational Therapy: Intergenerational Approaches, edited by
Susan I laiman (Vol. 10, No. I, 1990). “Can serve to enlighten both academics and clinicians as to
their roles in attracting students to become practitioners in mental health settings. Each article could
well s e n e as a catalyst for discussion in the classroom or clinic. " (Canadian Journal o f Occupational
Therapy)
Group Protocols: A Psychosocial Compendium, edited by Susan Haiman (Vol. 9, No. 4,1990). “Presents
succinct protocols for a wide range o f groups that are typically run by activities therapists, vocational
counselors, art therapists, and other mental health professionals. ” (International Journal o f Group
Psychotherapy)
Instrum ent Development in Occupational Therapy, edited by Janet Hawkins Watts and Chestina Brollier
(Vol. 8, No. 4, 1989). Examines content and concurrent validity and development o f the Assessment o f
Occupational Functioning (AOF), and carefully compares the AOF with a similar instrument, the
Occupational Case Analysis Interview and Rating Scale (OCAIRS), to discover the similarities and
strengths o f these instruments.
Group Process and Structure in Psychosocial Occupational Therapy, edited by Diane Gibson, MS, OTR
(Vol. 8, No. 3, 1989). Highly skilled professionals examine the important concepts o f group therapy to
help build cohesive, safe groups.
Treatment o f Substance Abuse: Psychosocial Occupational Therapy Approaches, edited by Diane
Gibson, MS, OTR (Vol. 8, No. 2, 1989). A unique overview o f contemporary assessment and
rehabilitation o f alcohol and chemical dependent substance abusers.
The D evelopm ent o f Standardized C linical E valuations in M en ta l H ealth>Principal Investigator:
Noomi Katz, PhD. OTR; edited by Claudia Kay Allen. MA, OTR, FAOTA; Com mentator: Janice P.
Burke, MA, OTR, FAOTA (Vol. 8, No. 1, 1988). “Contains a collection o f research-based articles
encom passing several evaluations that can be used by occupational therapists practicing in m ental
health. ” (Am erican Journal o f O ccupational Therapy)
E v a lu a tio n a n d T rea tm e n t o f A d o le sc e n ts a n d C h ild ren , edited by D iane G ibson, MS, O TR
(Vol. 7, No. 2, 1987). E xperts share research results and practices that have proven successful in
helping you n g people who suffer from psychiatric and m edical disorders.
Treatm ent o f the C hronic S chizophrenic P atient, edited by Diane Gibson, MS, O TR (Vol. 6, No. 2 ,1986).
“ R eflect/sj creative and fresh concepts o f current treatm ent fo r the chronically m entally i l l . . . .
R ecom m ended fo r the therapist practicing in psychiatry. " (Canadian Journal o f Occupational
Therapy)
The E valuation a m i Treatm ent o f E ating D isorders, edited by Diane Gibson, MS, O TR (Vol. 6, No. 1,
1986). "A wealth o f information. . . . C overs the subject thoroughly.. . . This book, w ell-conceived and
well-written, is recom m ended not only fo r clinicians working with clients with anorexia n e n ’osa and
bulimia but fo r all therapists who wish to becom e acquainted with the subject o f eating disorders in
g e n era l." (Library Journal)
P hilosophical a n d H istorical R oots o f O ccupational Therapy, edited by Karen Diasio Serrett
(Vol. 5, No. 3, 1985). "R ecom m ended as an easy-to-get-through background read fo r occupational
therapists and fo r generalists wishing a fu lle r acquaintance with the backdrop o f occupational
therapy. ” (Rehabilitation Literature)
Short-Term T reatm ent in O ccupational T herapy, edited by Diane Gibson, MS, OTR, and Kathy Kaplan,
MS, O TR (Vol. 4, No. 3, 1984). “Thought provoking and relevant to various issues fa cin g OTs in a
short term inpatient psychiatric setting. . . . Very rea d a b le. . . concise, well-written, and stim ulating."
(Canadian Journal o f O ccupational Therapy)
SC O R E : Solving C om m unity Obstacles a nd Restoring E m ploym ent, by Lynn Wechsler Kramer, MS, OTR
(Vol. 4, No. 1, 1984). "This needed book is an effective instrument fo r occupational therapists wanting
to ‘teach employable handicapped how to obtain a jo b in a com petitive (labor) market. * Very relevant
to professional p ra c tic e . . . a useful how -to instriunent. ” (The A m erican Journal o f Occupational
Therapy)
O ccupational Therapy with B orderline P atients, edited by Diane Gibson, MS, O TR (Vol. 3, No. 3 ,1983).
“Offers clinicians an opportunity to review current theoretical concepts, m anagement, and design o f
activity groups fo r this population. Well w ritte n . . . provides good reference lists and w ell-developed
discussions. " (The A m erican Journal o f O ccupational Therapy)
Psychiatric O ccupational Therapy in the A rm y, edited by LTC Paul D. Ellsworth, M PH. OTR, FAOTA.
and Diane Gibson, MS, OTR (Vol. 3, No. 2, 1983). This unique volume focuses on the historical
contributions, current trends, and future directions o f arm y occupational therapists practicing in the
m ilitary m ental health arena.
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 Brain Injury
and Gender Role Strain:
Rebuilding
Adult Lifestyles
After Injury

Sharon A. Gutman, PhD, OTR

Brain Injury and Gender Role Strain: Rebuilding Adult Lifestyles

After Injury has been co-publishcd simultaneously as Occupational
Therapy in Mental Health, Volume 15, Numbers 3/4 2000.

Routledge
Taylor ft f ranrii Cmip
LONDON AND NEW YORK
ftrain Injury and Gender Role Strain: Rebuilding Adult l ifestyles
After Injury has been co-published simultaneously as Occupational
Therapy in M enial H ea lth ™, Volume 15, Numbers 3/4 2000.

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L ib r a r y Hi i u ii^ re is C m u lo fliiifc -in -lN iM ic iitiu n D uta

(Oilman. S haron A.
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p. cm .
*n ivpuhli<hc<f *m ^uhjrK riii«ly isCkrup-aiionnl thcrap> in mrntal health, volume 15, num­
ber* 3/-I 21100.“
In*, hides h ih lii^ ra p h ic a l references mid index.
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palional therapy in m ental health. II. Title.
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 IND E X I N G & A B S T R A C T I N G
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<M CD-ROM version(s) o f the reference tools and in­
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Abstracts in Social Gerontology: Current Literature on Aging

A lzheim er’s Disease Education & Referral Center (ADEAR)
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CINAH L (Cumulative Index to Nursing & Allied Health
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Data-Star, and PaperChase. (Support materials include Subject
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CNPIEC Reference Guide: Chinese National Directory o f Foreign
Periodicals
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EM BASE/Excerpta Medica Secondary Publishing Division

<URL: http:llelsevier.nl>
Exceptional Child Education Resources (ECER) (CD/ROM from
SilverPlatter and hard copy)
Family Studies Database (online and CD IROM)
F IN D E X <www.publist.com>
M ental Health Abstracts (online through DIALOG)
Occupational Therapy Database (OTDBASE) <www.otdbase.com>
Occupational Therapy Index
O T BibSys
PASCAL, d o Institute de L ’lnformation Scientifique et Technique
<http://www.inist.fr>

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I dedicate this book to my parents, Evelyn and Jesse.
 ABOUT THE AUTHOR

Sharon A. Gutman, PhD, OTR, is Assistant Professor at Long Island

University where she teaches and conducts research in the Division of
Occupational Therapy. She earned her PhD in Occupational Therapy
and Rehabilitation Research at New York University. She has practiced
occupational therapy for approximately 10 years and has specialized in
traumatic brain injury rehabilitation for eight years. Dr. Gutman has
practiced in both sub-acute and long-term brain injury rehabilitation
for people with moderate to severe brain injury who are reintegrating
into community settings, returning to work, and rebuilding social rela­
tionships. Dr. Gutman has published a number of research articles
regarding long-term brain injury sequelae and the effectiveness of
brain injury intervention methods.
 Brain Injury
and Gender Role Strain:
Rebuilding Adult Lifestyles
After Injury

CONTENTS

Chapter 1. Introduction: “ I Never Thought This Is How

My Life Would Turn Out” 1

Chapter 2. The Histories of Four Men with TBI 13

Chapter 3. The Men’s Experience of Gender Role

Strain After TBI 27

Chapter 4. The Intervention Process: A Description

of the Treatment Methods Used to Alleviate
Gender Role Strain 49

Chapter 5. Each Man’s Intervention Story: Rebuilding

a Satisfying Adult Life After TBI 67

Chapter 6. Greater Satisfaction with Post-Injury

Male Gender Roles: The Men’s Self-Reports 111

Chapter 7. Conclusion: An Analysis of the Intervention’s

Effectiveness 127

Epilogue: My Final Thoughts 145

References 149

Index 151
 Acknowledgments
I thank Mary V. Donohue, PhD, OT, FAOTA, Jim Hinojosa, PhD,
OT, FAOTA, Dawn Leger, PhD, Marie Louise Blount, AM, OT, FAOTA,
Anne Hiller Scott, PhD, OTR, FAOTA, Winnifred Olivaria, Chris
Rosner, PhD, RN, Ellen Greer, MA, OTR, Pat Gentile, MS, OTR, and
Marianne Mortera, MS, OTR. I also thank the men who participated in
the intervention and who generously shared their lives with me for one
summer. This book was derived from research completed for my doc­
toral degree at New York University. I thank the American Occupa­
tional Therapy Foundation for a grant that made this research possible.