Acquired brain injury: Outcomes and rehabilitation

Acquired brain injury (ABI) as a result of head trauma, stroke, anoxia or poisoning affects about 1 in 200 people and can have devastating effects on functioning. Clinical research in this area has aimed to better understand outcomes following brain injury and helped develop effective approaches to rehabilitation. This work aims to optimise functioning and quality of life and has made important contributions to the lives of many people who suffer ABI, their carers and the community. I have worked in this area as a clinician and clinical researcher since 1997. Key aspects of my work have included:

  1. Development of the Potential Unlimited Programme for adults and adolescents with ABI in NSW. This experimental therapeutic programme seeks to facilitate adjustment to injury through enhancing self efficacy and developing and implementing participants’ own important personal goals in areas of work, relationships, leisure activities and independence. The programme includes a course of outdoor experiential education and extensive follow up group work. Pilot evaluations have indicated the programme has great promise. Evaluation of participants’ outcomes from a current programme run by Lucie Shanahan (South West Brain Injury Rehabilitation Service, Albury) and Outward Bound Australia is ongoing.
  1. Assisting in the development of the Neurotrauma Register of Tasmania, which conducted prospective longitudinal outcomes research with a representative sample of adults who sustained traumatic brain injury in Southern Tasmania from 2003. This register has seen over 1200 people and followed up with them on a number of occasions to five years following their injury. The register’s comprehensive database includes demographics, injury and treatment related information, as well as outcomes across physical, cognitive, emotional and social domains.
  1. Modelling clinical outcomes following traumatic brain injury. The database provided by the Neurotrauma Register of Tasmania provides excellent opportunities for clinical research that develops understanding of outcomes and leads to predictive modelling of outcomes across a range of relevant life domains. For example, one area I have worked onwas focussed on understanding quality of life (QOL) outcomes. The stages in developing predictive models of QOL outcome included examining the psychometric qualities of a suitable QOL measure, understanding pre-injury estimates of QOL and longitudinal outcomes following injury, then examining relationships between QOL and a raft of variables across domains of functioning (e.g. mood, post concussion symptoms, work and relationship status), before developing predictive models of QOL outcome. In collaboration with A/Prof. Clive Skilbeck and others from the University of Tasmania, work is ongoing and it is envisaged that this will join work in areas of predicting outcomes in relation to return to work, ongoing symptoms, mood, relationship status etc to be incorporated into a series of journal articles and clinical handbook.

Research grants

  • CSU Faculty of Arts Research Fellowship (2012) to support analysis and reporting on studies conducted in collaboration with the Neurotrauma Register of Tasmania. $40 000.
  • Motor Accident Authority of NSW and Lifetime Care and Support Authority (2010). Potential Untapped?: A waitlist-controlled trial of an integrated wilderness therapy and group programme for young people with ABI. $ 28 435.
  • CSU Faculty of Arts Seed Grant (2009). A clinical trial of an integrated outdoor education and group work rehabilitation programme for adolescents with acquired brain injury. $ 4 900.00
  • St John of God Foundation (2002). Development of the Potential Unlimited Programme. $78,000.
  • Motor Accident Authority of NSW Small Projects Grant (1998) to establish the first Potential Unlimited Programme with T. Goldsworthy. $ 7,000.

Journal articles

Skilbeck, C.E., Holmes, K.C., Slatyer, M., Thomas, M. & Bell, T. (2011) The factor structure of the Hospital Anxiety and Depression Scale (HADS) in a traumatic brain injury population. Brain Impairment, 12, 1,22-32.

Langley, J., Johnson, S., Slatyer, M., Skilbeck, C. & Thomas, M. (2010) Issues of loss to follow-up in a population study of traumatic brain injury (TBI) followed to 3 years post-trauma Brain Injury. 24, (7-8): 939-947.

Thomas, M. Skilbeck, C., Slatyer, M. (2009) Pre-injury estimates of subjective quality of life following traumatic brain injury. Brain Injury.23, 6, 516-527.

Thomas, M. (2004) The Potential Unlimited Program: An outdoor experiential education and group work approach that facilitates adjustment to brain injury. Brain Injury. 18,12,1271-1286.

Conference papers and posters

Troup, G., Thomas, M., Tyson, G., Kiernan, M., Skilbeck, C. & Slatyer, M. (2011. July) The factor structure of the Quality of Life Inventory in a representative sample of adults with traumatic brain injury. 4th INS/ASSBI annual meeting, Skycity, Auckland, New Zealand (Brain Impairment, July 2011, 12, suppl.).

Thomas, M. & Shanahan, L. (2010, May) The Potential Unlimited Programme: A review of pilot research and future directions for development. 33rd Annual conference of the Australian Society for the Study of Brain Impairment. Citigate Central, Gold Coast. (Brain Impairment, May 2010, 10, 1)

Langley, J., Johnston, S., Skilbeck, C., Slatyer, M., Thomas, M. (2009, May) Issues of loss to follow-up in a population-based study of traumatic brain injury. 32nd Annual conference of the Australian Society for the Study of Brain Impairment. Citigate Central, Sydney. (Brain Impairment, May 2009, 10, 1)

Thomas, M. Skilbeck, C., Slatyer, M. (2008, Nov) Subjective quality of life following traumatic brain injury: Towards improving service provision. Presented at the Annual conference of the College of Clinical Neuropsychologists, Glenelg.

Thomas, M. Skilbeck, C., Slatyer, M. (2008, Apr) Subjective quality of life following traumatic brain injury. Presented at the Annual Australian Health Outcomes Conference, Canberra.

Langley, J., Johnson, S, Slatyer, M.A., Skilbeck, C.E. & Thomas, M.D. (2008, Apr 9-12) Tasmanian Neurotrauma Register: issues of loss to follow-up after mild traumatic brain injury (mTBI), International Brain Injury Association, Lisbon, Portugal, pp.77 ISBN 0269-9052

Thomas, M., Skilbeck, C. & Slatyer, M. (2007, May) Correlates of subjective quality of life following traumatic brain injury. Presented at the 30th Annual conference of the Australian Society for the Study of Brain Impairment (ASSBI), Rydges Southbank, Brisbane.

Thomas, M., Skilbeck, C., Slatyer, M. (2006, Apr) Subjective quality of life in the first year following traumatic brain injury. Presented at the 29th Annual conference of the Australian Society for the Study of Brain Impairment (ASSBI), Rydges Jamison, Sydney.

Dr Matt Thomas

Lecturer in Clinical Psychology

02 6338 4173