Chris and Denise

A Unique Journey

Chris sustained a brain injury whilst working as a tree surgeon in Australia. The tree he was working on collapsed and he fell 50 feet to the ground. In this case study we meet Chris and his mother Denise, they talk openly about the consequences of his brain injury, the challenges they have faced together and the role of the Neurological Occupational Therapist, Zoe

This unique journey helps us to reflect not only on the life long and enduring consequence of brain injury for the individual, but also the essential role that families play supporting their loved one on their journey. From the early days of Chris’s recovery, through to the latter stages of rehabilitation, his parents and his immediate family have played an essential role in his recovery by offering practical and emotional support.

The support that he receives from his family provides security and stability, this in turn enables Chris to challenge his performance and participation with activities. Chris had clear ideas about how he wanted to spend his time and focus his efforts. Occupational therapy intervention was tailored to Chris’s unique needs and interests, the approach used considered his motivating factors within a therapeutic framework building confidence and facilitating skill acquisition.

Chris states that the focus of rehabilitation is about ‘getting back to normal’. Denise reflects on how she views her role as a facilitator for Chris, providing opportunities for him to achieve the goals that are important to him. The value of this ‘enabling environment’ cannot be underestimated in terms of the ‘scaffolding’ of social support that is offered to Chris, reinforcing the view that he can achieve his potential. This is reflected nicely in the family mantra… ‘onwards and upwards’.

“The doctor said to me one day “So Mrs Hall what would you expect for your son?”... I said to him “I would like him to walk and talk” … that’s all I wanted. He replied to me “Well, this could be it” … "At that time Chris could only open one eye and he was unable to move anything else.”


How we view ourselves is intrinsically linked to the environment we live in and our participation within daily activities. Skill acquisition and maintaining our view of our unique identity is closely related to our ability to sustain a pattern of participation that reflects who we are as an individual. 

Many of our clients with brain injury experience a significant change in their ability to complete activities that they would have done so successfully prior to their injury.

For Chris he viewed the purpose of the activities he completed as essential, he did not see the value of doing activities ‘for the sake of it’. It was important to Chris that activity choices had purpose and meaning, only then would they have any associated value. Appropriate activities were chosen that provided opportunities for Chris to develop his wellbeing and independence, whilst at the same time helping him to develop knowledge of his capabilities, limitations and effectiveness.

The activity choices made with the occupational therapist were grounded in the views that Chris held about himself. Moving back home with his parents enabled Chris to transition again into the familiarity of the family home. He was required to adapt to the rhythms and routines associated with a new but familiar environment. An environment that presented additional opportunities due to a purpose-built extension.

Residual impairments including memory and executive function difficulties made it challenging for him to initiate activities independently, and highlighted safety concerns regarding the use of kitchen appliances. Whilst at first the strategies that were introduced, including functional scripts and diary systems, were not well received by Chris, over time he learnt to value the benefits they brought him.

Find out more about Chris' latest progress in the kitchen here: Chris' incredible cooking progress with OT Zoe post brain injury.

Using a dynamic approach to occupational therapy rehabilitation, we assisted Chris with a number of areas.

  • An integrated approach with Chris and his immediate family that included sharing knowledge and cross pollination of ideas and recommendations
  • Time was spent on education to help Chris understand his ‘new found self’
  • We conducted functional assessments, looking at activities and the barriers to independence
  • We completed activities together to explore Chris’s strengths and reflect on challenges
  • We modified activities and used grading strategies to support skill acquisition opportunities for success
  • Activities were related to Chris’s valued interests and skills including horticulture, living a healthy lifestyle and keeping fit
  • Recreational activities and projects were explored with Thrive (a charity that uses gardening and horticulture to help individuals) to help with introducing a structure and purpose to the week
  • We provided education and support for Chris’s immediate family regarding expectations, pacing of activities, importance of routine and consistency and a need to provide a safe and familiar base from which Chris could explore his potential

Krysalis’s approach is totally centred around the individual and their needs, giving them the support and encouragement to move in the right direction. The result is that the client is left with an empowering sense of achievement. ‘Onwards and upwards’ is often declared when the small thing becomes part of the big picture.



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