The experience of appraisal, coping and adaptive psychosocial adjustment following traumatic brain injury: A qualitative investigation

Purpose: The experience of appraisal and coping in relation to psychosocial adjustment was explored with individuals who had sustained a traumatic brain injury. Methods: Nine participants were interviewed using a semi-structured schedule. Interpretative phenomenological analysis was used to analyse the data and highlighted four over-riding themes. Results: The emergent themes included: (1) 'waking up': understanding TBI; (2) 'I keep going': coping with TBI; (3) I knew I'd get better': beliefs about TBI; and (4) 'the benefits have far outweighed the consequences': searching for positives. These themes highlighted the adaptive and fluid way in which participants coped over time. In addition, the balance between perceptions of luck vs controllability and optimism vs realism were evident for many participants. All but one participant showed adaptive adjustment; therefore the non-adaptive case was used to critique the emergent themes. Conclusions: The case of non-adaptive adjustment illustrated less fluidity in terms of the coping strategies utilised, little perceived controllability and a greater degree of externalizing blame. The findings give some direction to neuropsychological rehabilitation with regard to the pliable nature of appraisals and coping and their potential to facilitate adaptive adjustment.