Knowing what is not seen: A scoping review on invisible brain injuries and their psychoeducation

Abstract

An acquired Brain Injury (ABI) can cause a wide range of motor/sensorial, cognitive, behavioral and socioemotional deficits, impacting the process of community reintegration and decreasing mental health and quality of life. Clinicians and ABI survivors have stated that invisible deficits can generate important barriers for community reintegration. Despite this growing interest for invisible impairments and their impact in the rehabilitation process, to date there isn’t a clear conceptualization of them, their impact and how to address them therapeutically. This review was conducted
following PRISMA methodology for the systematic synthesis of knowledge related to invisible brain injuries, their definition, associated consequences and existing interventions. Data from this review suggests that an invisible brain injury is characterized by a lack of visual markers, a difficulty to be noticed by others and the exclusive recognition by patients themselves. Because they tend not to be recognized by others, invisible brain injuries contribute to enlarge the discrepancy between pre and post injury self, as well as the generation of unrealistic expectations towards the survivor. The invisibility of deficits can compromise the referral of survivors to specialized rehabilitation services or professionals, as well as adherence to treatment. Invisibility of impairments can also compromise the return to educational contexts due to misinterpretation of cognitive and behavioral changes. In working environments, invisible deficits can negatively impact the necessary accommodation of tasks, workload or routines, as well as