A Longitudinal Evaluation of an Alcohol Related Brain Injury Specialist Residential Rehabilitation Service
BACKGROUND: Initiatives are required in order to identify and provide rehabilitation for individuals with Alcohol Related Brain Injury (ARBI). However, there is very little evidence as regards the outcomes and lived experiences of the patients who often have a myriad of corollary problems including alcohol dependency, homelessness, family dysfunction and contact with the criminal justice system. Leonard Cheshire has developed a specialist residential rehabilitation facility for people in the UK with Alcohol related Brain Injury (ARBI). This service is one element in the network of services required to support people with ARBI.
METHODS: This mixed methods study explored the effectiveness of an ARBI treatment modality available for patients in Northern Ireland on an inpatient basis. It utilised a range of quantitative measures to assess psychological well-being, functional ability, familial and social relationships/ community participation/ cognitive ability and maintaining abstinence at base line and at five junctures throughout the project time frame. Qualitative data was collected over 4 timepoints: baseline (n=20), 6 months (n=15), 12 months (n=6) and at follow up post discharge (n=4). Remote interviews were conducted with family members (n=10). Staff interviews captured views on the implementation of the model as well as their perceptions of strengths, weakness and benefits of the service and external influences that might affect its implementation and effectiveness.
FINDINGS: There were significant differences in scores across T1- T2 and T3 time points for HADs Depression, Anxiety and HONOS scores. Qualitative findings for residents across 4 timepoints from baseline to time of discharge indicated an overall improvement in all outcomes. Overall, relatives stated that the ARBI model had significantly improved outcomes for their loved ones and had provided a ‘safe space’ in which they could recover and rebuild themselves. Staff from within the unit felt that the ARBI multidisciplinary holistic approach had a positive impact on residents’ outcomes and was cost effective in that these individuals were no longer frequenting A&E departments and the judicial system and instead were now able to live stable lives without relentless chaos.
CONCLUSION: Overall, the ARBI holistic intervention significantly improved psychological wellbeing, social relationships/ community participation, cognitive abilities and abstinence from alcohol, particularly when residents were residing in the unit. Whilst the residential unit provided structure and a protective environment, residents required ongoing support post discharge for their addictive behaviours. An outreach intervention for these individuals is currently being piloted.
