I had the pleasure of interviewing Jennifer Bommer, a Licensed Professional Counselor and private practice owner of Texas Neuro Trauma Counseling, PLLC www.txneuro.org.
She was very informative in expanding on counseling and responding with strategies, resources and how to initiate a referral process. What I found most unique about her was that not only does she provide counseling and cognitive rehab services, she also provides educational support to help a client understand their diagnosis. As an SLP we spend a lot more time with patients than other professionals so the educational piece I think gets left behind for other professional. Here are excerpts from our interview that highlight the main points
Question #1 Given our unique role as Speech Language Pathologists, how would you address the dynamics between a family and a patient? (When there’s a problem)
We call it attuning to that person or whoever is in the room and can be helpful for bringing down that panic and anxiety that is presenting a protective mechanism. If they’re not listening and they’re not respecting somebody that does have authority and so kind of act…you say “ OK I hear you I know this is stressful.” And being able to say these are my recommendations based on what I see. It is helpful to have a kind of mediator role between the patient and the family.
Question #2 Do you think I have a role in talking to them (family and/or patient) about getting counseling help separately from speech services?
I think that the language that is used when making a referral is really important. I think providing that option that resource and explaining why there’s utility to it is really important so that that person doesn’t feel dismissed or passed off. This is somebody that can help you navigate this and solve problems because I think there is still leftover idea that therapy is coming in and kicking your feet up on the couch talking about feelings; it’s much more functional direct approach that is targeted or more acute situations like this.
I think the only thing I would add is just that anything you can kind of slip into that conversation that communicate that it’s OK not to handle the situation it’s OK that you’re struggling to navigate this because there is always potential benefit from having different coping skills, adapting strategies.
Question #3 Brain injury specific, what references do you have for frustration tolerance?
In my experience there’re the biggest variable is is how much impulsivity somebody has tied to their emotional regulation, especially with anger and frustration tolerance. If they’re so impulsive, they’re not even aware of what’s happening, but they do have awareness and teach them how to recognize they’re getting frustrated that they’re getting angry. What does that feel like physically then what does it feel like mentally emotionally triggers and I think when people gain confidence and identifying that and identifying what environments tend to make that happen and they feel like they have more control over. But I’m on any kind of sensory component that’s grounding so it could be any really cold on your neck on your wrist in your hands. Anything that’s warm soothing those intense physical sensations or distracting, but tend to diffuse that most immediate anger, frustration, and kind of back to baseline.
Something accessible to whether somebody is in session or at home at work even to keep some ice in the freezer or some kind of towel. They can heat up their neck. It is very helpful in putting a lid on their frustration
Me: Does pressure or vibration help?
Jennifer: Sensations are shooting but, I think sensations that are more of an intensity and of course I don’t mean that necessary painful or a problem. The distraction just gives that person more time more space to regulate themselves
Question #4 What suggestions do you have gap between our services?
You know some days I just feel like brain injury especially when it becomes chronic it’s like trying to eat soup with a fork I guess aspirationally can we talk about this. You know, if clinicians had more time to collaborate with each other that would be really helpful. I think continuity of care for chronic treatment of a patient that is overwhelmed is helpful.
I hope you gained some insight into counseling from the support of Jennifer Bommer. I wished I had more time to ask her more questions but, she agreed to more in the future. What do you want to know ? Let me know your questions and thoughts.
