THI Part 2 of 3: Screening for Traumatic Head Injury in a Basic Clinic Setting

This webinar, presented on 9/15/2010, features R. Richard Sanders. It is part 2 of 3 in a series about traumatic head injury in torture survivors.

This webinar is part of the National Capacity Building (NCB) webinar series. NCB is a project of the Center for Victims of Torture.


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Wednesday, 15 September 2010

Don't miss the other two parts of this webinar series!

History and Evidence of Traumatic Head Injury (THI): Basic Concepts and Principles in the Care of Torture Survivors with THI (THI Part 1 of 3)

Family and Patient Support: New Approaches to Fostering Dialogue and Hope (THI Part 3 of 3)

In the 1950's Dr. Ettinger and later in the 1980s Goldfeld and Mollica identified Traumatic Head Injury (THI)/leading to Traumatic Brain Injury (TBI) as a common and severe sequelae of trauma and other forms of external violence. THI/TBI is now likely recognized as the signature injury in American combat troops returning from the wars in the Middle East. Yet THI/TBI related to medical and psychiatric problems are difficult to diagnose and treat even in specialized clinics for survivors of torture and combat veterans.

This webinar elaborates on part 1 of the series in that it aids mental healthcare providers more specifically in screening for Traumatic Head Injury ( THI) and Traumatic Brain Injury (TBI) in a clinic setting. This webinar is broken down into three main areas: definitions and characteristics of THI and TBI, how to identify and screen for TBI/Mild TBI, and therapy principles and referral options. Richard Sanders expands on these areas by discussing how to treat patients who suffer from chronic post-concussion symptoms, the prevalence of TBI and who commonly suffers from it, types of force that affect the brain and how each manifests itself patient symptoms and behavior, the development of other neurological problems, and later consequences of TBI. He also includes successful ways to educate patients on their diagnoses and includes many other resources, at the national and local levels, that can be of use to practitioners. Sanders also uses many visual aids to better explain the information.

Objectives for this webinar

1. Learn simple screening procedures for identifying the mapped neuropsychological symptoms and disabilities associated with THI/TBI in torture survivors.

2. Utilize approaches to the education and care of trauma survivors supporting their THI/TBI related medical, cognitive, and psychiatric disorders in free standing torture treatment centers and those embedded in primary health care.


R. Richard Sanders, M.S. CCC, M.T.S. holds the rank of Clinical Expert in Speech-Language Pathology at Spaulding Rehabilitation Hospital with interests in the areas of acquired brain injury and counseling. He has a B.A. from the University of North Carolina at Chapel Hill and a Masters in Communication Disorders from Boston University. He completed a Masters in Theological Studies from Harvard Divinity School focusing on counseling individuals and families after difficult life events. He is Adjunct Clinical Associate Professor at Boston University Sargent College, teaching Acquired Cognitive Disorders and is Clinical Instructor at the Massachusetts General Hospital Institute of Health Professions, teaching Theoretical and Practical Aspects of Counseling across the Lifespan. He has developed innovative treatment models including Family Strategies Group, which includes the spouse or significant other in the treatment of the person with brain injury and Executive Skills Group, which teaches strategies to improve organization, planning and self-monitoring skills. He has presented at numerous national and regional conferences over his thirty-year clinical and academic career.

Suggested readings

American Congress of Rehabilitation Medicine, (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (3), 86-87.
Bryant, R.A. Disentangling mild traumatic brain injury and stress reactions. The New England Journal of Medicine 2008; 358:5: 525-27. PDF available
Chen, J.K. et. al. A validation of the post concussion symptom scale in the assessment of complex concussion using cognitive testing and functional MRI. J Neurol Neurosurg Psychiatry. 2007 Nov;78(11):1231-8. Epub 2007 Mar 19.
Glenn. M. Post-concussion syndrome, Essentials of Physical Medicine and Rehabilitation, 1st Edition (ed. Silver J, Frontera W) 687-693. Hanley & Belfus, Philadelphia, 2001.
Hoge, C.W.,, Mild traumatic brain injury in U.S. soldiers returning from Iraq. The New England Journal of Medicine 2008; 358:5: 453-63.
Kay, T. (1986). Minor head injury: An introduction for professionals. (1-12) Washington, D.C.: Brain Injury Association. PDF Availble
King, N.S., et. al. The Rivermead post concussion symptoms questionnaire: a measure of symptoms commonly experienced after head injury and its reliability. Journal of Neurology (1995) 242: 587-592. Springer-Verlag.
Mateer, C. & Mapou, R. (1996). Understanding, evaluating, and managing attention disorders following traumatic brain injury. Journal of Head Trauma Rehabilitation, 11 (2): 1-16.
Mateer, C., Sira, C., & O’Connell, M. (2005). Putting Humpty Dumpty together again: the importance of integrating cognitive and emotional interventions.J ournal of Head Trauma Rehabilitation 20 (1), 62-75.
Ruff, R. (2005). Two decades of advances in understanding of mild traumatic brain injury. Journal of Head Trauma Rehabilitation. 20 (1), 5-18.
Sohlberg, M., & Mateer, C., (1989). Training use of compensatory memory books: a three-stage behavioral approach. Journal of Clinical and Experimental Neuropsychology, 11 (6), 871-891.
Zasler, N., Katz, D., and Zafonte, R. (Eds.) Brain Injury Medicine New York: Demos Medical Publishing, 2007.

Neurorehabilitation Survey - (attached) tool developed by Spaulding Rehabilitation Hospital; used for intake and identification of traumatic head injury


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