Award-winning support group is helping brain injury patients get their lives back on track

People who have suffered a life-changing brain injury are finding new ways to regain confidence and get their lives back together, thanks to an award-winning support group.

The Positive Psychology Group for people living with an acquired brain injury is aimed at helping participants manage difficult emotions and experiences while learning and practicing techniques to build self-belief and positivity.

Devised by Swansea Bay consultant clinical psychologists Dr Zoe Fisher and Swansea University head of research Professor Andrew Kemp, the group taps into the latest scientific evidence about well-being.

Participants identify their strengths and values and explore new ways to use them and to set goals.

Pictured above, from left to right, research impact officer Kelly Davies, Zoe Fisher, Andrew Kemp, research assistant Alina Dray, team coordinator Suzanna Charles and clinical trial coordinator Lowri Wilkie.

Praise for the group’s impact has been glowing. So much so, it won the health board’s Living Our Values Commitment to Research and Development Award for 2023.

One patient said: “I feel it's been a huge transformation in a really short time,” while another added: “I walk in all anxious and shambolic in the morning and I'd leave, sometimes tired, but always feeling that there was hope in the future and almost ready to take on anything.”

The sessions also explore techniques to help participants feel more connected with other people and the natural environment.

Dr Fisher believes healthcare has traditionally tended to focus on reducing mental health difficulties - missing opportunities to build well-being. The theory behind the new approach is to help participants build a sense of well-being, as opposed to simply focusing on an illness-based model of support.

She explained: “Lots of patients were telling us that what they really wanted was to feel valued again, to regain a sense of meaning and purpose in their lives - to feel useful. We have tried to build this intervention to address this.

“Many of our patients described the feeling of not living but existing, sitting in an arena watching their life from the stands rather than being part of the show.”

The question of how to define well-being has been the product of seven years of collaboration between Dr Fisher and Professor Kemp. It has seen them publish an influential well-being theory called the GENIAL model, which focuses on building positive emotion, meaning and purpose in people’s lives, as well as connections to themselves, other people and nature.

Dr Fisher said: “Brain injuries can have a very serious impact on all aspects of a person’s life and ultimately many people do have to live with some degree of impairment, even after neuro-rehabilitation.

“I guess it struck us that if our efforts were to just try to remove distress and reduce impairment, then we are missing opportunities to help people to lead fulfilling lives. We wanted to build a service to also promote health and wellbeing.

“We spent some time in one of the sessions helping participants to identify their core strengths and values.

“To remind them of this, we entered their strengths into an artificial intelligence image generator and it created a unique image to represent each person’s strength (see picture, left) – we used these images to personalise the front covers of a manual which we provided for the group participants.”

Each session is managed by two clinical psychologists and two mentors. Mentors are patients who have been through the service previously and now volunteer to help the group by providing their experience and support.

By helping others, mentors have described how being involved with the group in this way has had an additional positive impact on their sense of self-worth. 

One mentor said: “When I’m mentoring, I do feel valued. I feel like somebody.”

Dr Fisher added: “I see the group as an important first step in building wellbeing and translating our theory into action.

 “It provides peer support and discussion and a safe place to feel understood, explore new ideas and try new approaches.

 “We’ve created many partnerships in the community, with organisations like Surfability, which provides adapted and inclusive surfing experiences and Cae Felin Community Supported Agriculture, a project which is aimed at supplying Morriston Hospital with fruit and veg.

 “Some people like to talk, some people like to light fires and build stuff, some love sport. We try to build something sustainable into their lives, something they love.

“The idea is if we help people link up with organisations in the community, when we discharge them they have something they’re involved with and enjoy, alongside the network of friends they’ve met through the group.”

Dr Fisher and Prof Kemp are finalising a Health and Care Research Wales funded feasibility study and are now hoping to secure additional funding to run a multisite randomised control trial to further examine the benefits of the Positive Psychology Group.

They’re also planning on publishing their treatment manual so they can share their work more widely with other clinicians working in the area.

“We have now published several evaluations of our groups  and participants have told us they felt more able to cope with difficult experiences and the aftermath of brain injury,” added Dr Fisher.

“They said some lovely things, overall we’re delighted and hope that other services can potentially benefit from adopting similar interventions to this one.”