"You can't change the ABI": practitioner insight into the rehabilitation of health and social needs associated with aggression after acquired brain injury.

Abstract

Aggression and offending can be common after Acquired Brain Injury (ABI). This may be partly attributed to ineffective community-based rehabilitation for health and social needs related to these behaviours. As practitioner perspectives can elucidate the realities of service provision and barriers in rehabilitation, the aim of this study was to explore their perspectives on the effectiveness of rehabilitation for persons with ABI. Individual semi-structured interviews were conducted over Zoom with eight practitioners (75% male, 25% female) recruited through purposive sampling across mental health (4), social (2), and physical health (2) services. Inductive codebook thematic analysis was employed. Two main themes emerged: <i>Understanding ABI Through Experience</i> and <i>Creating Accommodations to Service Delivery</i>. The findings highlight that poor rehabilitation outcomes can be due to barriers, including a lack of ABI-specific education or interventions, the complexities of co-occurring needs, aggressive behaviour displayed by individuals with ABI, and service inaccessibility. Ineffective rehabilitation can perpetuate the negative impacts of health and social challenges and increase the risk of aggression and incarceration. Improving access to appropriate ABI-informed community-based support is paramount to address needs and reduce the likelihood of such needs increasing the risk of aggression and incarceration.