Effective workplace communication with employees with acquired brain injury
- Implementation guide
- Acquired Brain Injury (ABI)
- Talking about talking and listening
- Talking about learning
- Talking about the job
- Talking about tools
- Talking about safety
- Talking about quality and quantity
- Talking about teams and workmates
- Talking about problems
- Talking about changes
- Talking about futures
Talking about teams and workmates
Being part of a team and understanding what teamwork means are important in all workplaces. Helping people to develop the behaviours and attitudes that contribute to a team approach is an ongoing task.
Working involves getting on with others. We expect people to work cooperatively and contribute as team members. These skills involve quite complex abilities and are often difficult for people with ABI. Some of the difficulties can be caused by:
- not understanding what is expected of you when you work with others – for example, respect for individual differences, respect for the rights of others, cooperative effort, etc
- a person only being able to understand things from their own viewpoint. Imagining or empathising with the way another person thinks or feels may be far too abstract for them
- confusion of emotional expression. Interacting with people involves our emotions. People with ABI often have problems interpreting their own emotional states and correctly identifying emotions in other people
- limited understanding of 'teamwork' or 'teams' because they are abstract concepts. People with ABI may need to have these abstract concepts linked with things that are familiar to help them learn the attributes and behaviours that make up 'teamwork'
- difficulties following the 'rules' of communication with others. People with ABI sometimes have problems taking part in conversations because of cognitive impairments associated with their brain injury.
Some effects of a brain injury can make it particularly difficult for employees with ABI to work in a team. These include:
- impaired social skills that result in self-centred behaviours
- difficulties in making and keeping friends
- difficulties understanding and responding to the subtleties of social interactions
- irritability, anxiety and depression
- disinhibition, including temper flare-ups, aggression, swearing, lowered frustration tolerance, and inappropriate sexual behaviour.
Once or twice a week, Carmen, normally very polite and refined in her behaviour, gets upset about something and lets loose with a torrent of abuse, loudly cursing everyone in sight. Legends have grown over the years about how long and how loudly she can curse. Anyone unfamiliar with her outbursts is astounded if they happen to be around when they occur. New workers always take a long time to get used to her, and there are people who have worked with her for years who still really fear her temper flare-ups. She is rarely physically violent, although she has, on a few occasions, threatened to throw things at people.
Alex's behaviour can be very challenging and his future at Merrinvale is uncertain because of it. Nobody wants to work with him and some employees seem frightened of him. He can be verbally aggressive and gets angry easily.
Socially, Alex is still disinhibited. He intrudes on personal space, interrupts constantly and often makes very confronting remarks to people. He touches people inappropriately and sometimes makes explicit sexual suggestions to female employees and supervisors.
When asked to help or work with others, he will complain loudly, Why should I work with any of them? They're freaks! All freaks!
From Fran's notebook
I'm filling in for Nathan while he's on sick leave. I am so stressed myself after a day there I think I need leave! I'm really frightened of that Alex and I can't believe the language Carmen uses. I used to think she was so ladylike. I've never heard anything like it in my life. I went up to her though and confronted her; told her I didn't have to listen to gutter talk and she had better stop or I'd call Bob in.
- Focus on the behaviour not on the person. Don't blame the person for their behaviour. Don't say, Alex you are rude. Rather say, Alex, it is rude to call your team mates those names.
Do the same with positive behaviours – respond positively to the behaviour rather than only praising the person saying. Alex, it was great that you helped Carmen with the last of the boxes. Helping other people when they need it is part of being in a team is much more likely to lead to the person behaving in the same positive way in future than saying something like, Alex you are a nice person for helping Carmen.
- Deal with disinhibition. When a disinhibited behaviour first occurs, quietly tell the person what they have just done and that it is not acceptable. Don't explain why. Go on with what you are doing. Ignore the behaviour if it recurs. If the behaviour is affecting others, you may need to quietly redirect or change the person's activity or situation. Don't take the behaviour personally, and don't react emotionally.
- Deal with verbal aggression. Abusive and aggressive language as well as threats of aggression are common following ABI. Try to increase the employee's sense of worth, their social and communication skills, and acknowledge their feelings and wishes. It is rarely useful to argue or reason with someone who is unreasonably argumentative.
- Deal with self-centredness.
- Don't allow the employee to think that all their demands will be met. Set rules and keep to them.
We do this at 11 o'clock.
- Encourage them to see other viewpoints.
You say this about it. What do you think Jasper would say?
- Provide positive reinforcement whenever consideration of others is shown.
You asked me how I was today; that was really nice.
- Recognise learning needs. Realise that an employee with ABI will often need to learn new behaviours – communication, social or self-control skills – to replace problem behaviours. By teaching the person new skills you are adding something positive to the employee's life, rather than just limiting or restricting the problem behaviour.
- Help build communication skills. Assess the employee's functional social skills. Do they know how to:
- open or finish a conversation
- make a plan to tell someone something and carry it through
- ask for information or get directions
- let someone know that they are listening to them?