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Effective workplace communication with employees with acquired brain injury

Chapters

Talking about problems

Developing problem solving skills will assist supported employees to participate effectively in the workplace. You will need to use a range of communication techniques to help them do so.

The skills of identifying when a problem exists, and then solving it, are often very difficult for employees with ABI, particularly if there is damage to their frontal lobes. The frontal lobes enable us to think abstractly and creatively, to consider several aspects of a situation simultaneously, to make complex decisions and solve problems. Damage in this area will create difficulties in:

If I'm going to finish packing this by 11 o'clock, I will have to go a lot faster.

Normally it only takes 15 minutes to pack one carton but it's taking longer today because the conveyer had to be stopped.

And if I'm late getting them packed, we'll miss the delivery at 12 o'clock.

I don't like this, I don't want to do it. But I must relax and just work through it.

I get angry every time I have to work faster and then I walk out. I will try not to do that this time.

I don't know what to do … there's nothing I can do. I'd better ask Paul what to do.

It's not my fault; got nothing to do with me. Ohh … actually it is my job though.

We won't miss the delivery if we get a couple of the guys from Bill's section to help out for an hour.

Support workers can assist employees with ABI improve their problem solving skills by training them to:

When talking about the problem solving abilities of employees with ABI, it is critical to remember that there will be vast differences between individuals as well as quite pronounced skill differences and fluctuations within individuals at different times.

Don't be surprised for instance, if one of your employees with ABI can't work out how to repack two items into a box yet can sit down at tea break and complete a very difficult logic puzzzle or crossword.

Making decisions is a critical part of problem solving. It requires us to think and question.

It is a not a simple activity. We must take our thinking down a very particular route. Employees with ABI need to be given opportunity and encouragement to observe what is going on and interpret and make sense of what they see.

Lallie's story

Lallie is in her late 30s and has ABI. She came to work at Merrinvale about six years ago where she quickly assumed a 'leadership' role amongst the other employees. Lallie talks a lot about what she has done in the past but there are many inconsistencies in her stories. She tells you she has been, at various times, a police officer, an army corporal, received awards for bravery, and been an ambulance driver in 'war zones'. She certainly shows evidence of some highly developed skills but is also frequently the cause of big problems in the work area. Her supervisor, Nathan, says, 'Lallie causes problems because she takes it upon herself to solve everyone else's problems'.

Lallie gets very little work done herself. She rushes around telling people to do it this way, fix that up, move those there, put this away, cut something into different sizes, have a rest, move faster ... and so it goes on, day after day.

Her 'advice' often results in major problems. Recently Lallie told Peter to jump into the rubbish skip to retrieve a cutter she said he'd thrown in there. Against all the safety rules, Peter climbed into the skip and then couldn't get out. Lallie vaulted over the side of the skip, shouting, 'Get help! Get help! it looks like he's badly hurt!'.

Employees were screaming, someone pushed the emergency alarm button, Bob and Paul came running, Nathan had a complete stress attack, and the pastry cutter was found lying on the bench where Peter had put it down. Peter emerged from the skip unharmed.


From Em's notebook

Trevor sat with me at lunch today and asked me if I knew the answer to the St Ives riddle. (As I was going to St Ives, I met a man with seven wives ...) I did what he said everyone did which was try to count all the cats and kittens and wives and ended up with something like 51 people going – which was absolutely wrong!

He told me the key to that one and then gave me another really complicated puzzle about missionaries and cannibals wanting to cross a river. You had to work out how many trips the boat had to make to get all the missionaries and cannibals across without anyone being eaten. The solution was amazing and Trevor was able to show the reasoning behind the number of trips they had to make. He's got such a brilliant mind and I've never known anyone with so much knowledge of all sorts of things. Yet he gets in such a mess when the simplest little thing goes wrong on the packing line.

Strategies

  1. Break down complex tasks. For example, if the person has trouble working out how to start a machine, create a list of steps and decisions that need to be made in order to do this and help them gradually work through the steps.
  2. Assist decision making. You can support decision making by:
  1. Support employees as they attempt to solve problems.
  1. Reduce frustration. An employee with damage to the frontal lobes may become very frustrated with problem solving. Helping the employee to think of possibilities, make plans and follow them through. This may involve:

What if you packed it this way? Might it fit better?

To make sure we've got them all, why don't we count them before we seal the box.

It's more important to get these cartons on the pallet. They are being picked up at 4 o'clock. You can do the other ones after this lot have gone.

You said you'd put a tick on the list when you finished each carton. Have you ticked that one off?

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