“They will Leave You Lost”: Experiences of a Gifted Black Male with a Traumatic Brain Injury

"Somewhere along the line, your mask isn't going to be fitting right": institutional racism in Black narratives of traumatic brain injury rehabilitation across the practice continuum

BACKGROUND

Over two decades of research about traumatic brain injury (TBI) rehabilitation emphasized the persistence of racial health disparities in functional outcomes that disproportionately impact Black populations without naming or addressing racism as the root problem. Further, the experiences of Black people with TBI have yet to be documented and accounted for in scientific scholarship from the perspectives of Black persons in Canada.

PURPOSE

This study intended to examine the rehabilitation narratives of Black TBI survivors, family caregivers, and rehabilitation providers and use critical race theory as a conceptual framework to understand how anti-Black racism manifests in those experiences.

METHODS

Through critical narrative inquiry informed by a critical constructivist paradigm and a critical race theory lens, in-depth narrative interviewing were conducted with seven survivors, three family caregivers, and four rehabilitation providers. Data were analyzed using reflexive thematic analysis within and across groups of participants to conceptualize themes and sub-themes.

FINDINGS

Themes captured how racism becomes institutionalized in TBI rehabilitation: (1) the institutional construction of deficient Black bodies, (2) the institutional construction of rehabilitation access, (3) the institutional investment in resisting and approximating whiteness in rehabilitation practice, and (4) the institutional construction of deficient Black futures.

CONCLUSION

Study findings point to the dire need to ensure rehabilitation programs, services, and the delivery of care are not determined based on inequitable practices, racial biases and assumptions about Black people, which determine who deserves to get into rehabilitation and have opportunities to be supported in working towards living a full and meaningful life.

The student journey: Living and learning following traumatic brain injury

Primary objective: In this research we set out to gain further understanding of the experiences of students participating in secondary and tertiary education following TBI: exploring academic and non-academic factors, as well as changes in experiences over time.Methods and procedures: A longitudinal, qualitative investigation was completed. 12 students (17-32 years) completed up to three in-depth interviews over a period of 4-15 months, capturing atotal of 30 time points. Data were analyzed using grounded theory methods.Main outcomes and results: Students' participation experiences were unique and varied with different timelines and outcomes, however they shared many similar critical points. We interpreted their experiences as a student journey traveling through four significant landscapes, "Choosing to study", "Studying", "Deciding what to do", "Making the next step." Journeys involved complex processes of living and learning. Moving along the pathway was not always smooth or straightforward.Conclusions: Students' experiences of returning to study following TBI can be interpreted as a complex journey of living and learning. Four important stages of the journey provide clinicians and educators with landscape features that can provide a structure for exploring supports to address both academic and non-academic factors to assist students in their study journey.