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Abstract -- Traumatic Brain Injury (TBI) is complex and unique, encompassing a myriad of challenges for the person with the injury, rehabilitation counselors, and the survivor's family and friends. The challenges can affect work and family reintegration. Sustaining a TBI can result in familial strain as it affects the role and function of the individual with TBI in the family. Manifestations can include financial, psychological, and caregiver-related stress. Since individual and family coping mechanisms interrelate, it is important for rehabilitation counselors to appreciate theoretical constructs of family resiliency. This article explores the rehabilitation counselor's need to assess the connectedness of family resiliency and community reintegration outcomes in persons with TBI; it also underscores the importance of evaluating family-inclusive rehabilitative interventions.

Traumatic Brain Injury (TBI) is a disability that rehabilitation counselors in the United States frequently encounter. On average, approximately 1.7 mil lion people sustain a traumatic brain injury annually and TBI contributes to a third of all injury-related deaths in the United States (Faul, X, Wald, & Coronado, 2010). Further, approximately 3.2 mil lion Americans, with secondary residual TBI disabilities, have long-term needs for assistance in performing their daily life activities (Corrigan, Selassie, & Langlois, 2010). Rehabilitation counselors and other healthcare professionals encounter and serve persons who have sustained a TBI; many of these are Veterans who have returned from war with combat-related brain injuries.

TBI often results in a dramatic change in the individual's life-course, significant disruption in family functioning, dim i nu tion in earning potential and costly expenses over a lifetime (Finkelstein, Corso, & Miller, 2006; National Institutes of Health, 1998). Coping and adjustment to the initial injury and long-term care implications of TBI affects the individual, their family members, friends, and community (Dillahunt-Aspillaga et al., 2013; Groomes & Linkowski, 2007).

Since individual and family coping mechanisms are often interrelated, rehabilitation counselors who serve clients with TBI may benefit from understanding constructs of family resiliency. The Resiliency Model of Family Stress, Adjustment, and Adaptation (McCubbin, Thomp - son, & McCubbin, 2001) illuminates the importance of family resources, coping mechanisms, and appraisal in the adjustment process. This article highlights the relationship between family resiliency and community reintegration outcomes in persons with TBI; it also offers guidelines for rehabilitation counselors to incorporate this knowledge into rehabilitative interventions. Key issues include connections between theory and practice, suggestions for projecting community reintegration outcomes, and the significance of specific coping mechanisms as related to resilient families in this population.

TBI and Family Strain

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Julianne Frain, PhD, CRC, ABVE, is a Vocational Rehabilitation Consultant who provides quality expert vocational services. Since 2008, Dr. Frain has worked with hundreds of claimants, giving expert advice on wage-loss and re-employment issues.

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