Aim

This module aims to increase awareness of the impact of traumatic brain injury (TBI) on people’s sexuality, and increase your awareness of your own attitudes towards sexuality. It also offers useful strategies to enhance the sexual lives of clients with TBI, and to manage sexually inappropriate behaviour.

Rationale

Traumatic brain injury can have negative consequences for a person’s sexual functioning. Staff often find this a challenging area of work. Increased awareness of one’s own attitudes, combined with accurate information and practical skills, can enable staff to work more effectively in this area.

Outcomes

At the end of this module, you should be able to:

6.1 Awareness

• define sexuality
• identify sexuality issues for people with TBI, and how these issues affect their family members and workers in the field
• clarify personal and professional values on sexuality

6.2 Rights, needs and issues

• recognise the sexual rights and needs of clients with TBI

6. 3 Communication

• recognise verbal and non-verbal components of communication about sexuality
  identify clients’ special needs in verbal communication
• match verbal and non-verbal communication for clarity in dealing with clients’ sexuality
• monitor non-verbal interactions with clients (eg. tone of voice) for more effective
  communication about sexuality

6. 4 Treatment strategies

• identify strategies to address clients’ sexual health concerns

6.5 Inappropriate behaviour

• understand different causes of sexually inappropriate behaviour
• identify strategies for establishing professional boundaries between client and worker
• develop strategies for verbal feedback to clients about disinhibited sexual behaviour
• develop effective ways of responding to inappropriate sexual behaviour.

Philosophy

The underlying philosophy of this module recognises two different dimensions in addressing sexuality issues among people with TBI.

The first is promoting sexual wellness, addressed in the first two-thirds of the module. This includes sexual function (eg. erectile problems, orgasm problems, ejaculatory problems, arousal problems), masturbation, physical positioning and sexuality, contraception, safer sex, pregnancy issues, accessing sex workers and the like.

The second dimension is the management of sexually inappropriate behaviour (eg. inappropriate sexual talk or touching, exhibitionism, coercive sexual behaviours) addressed in the final third of the module.

Additionally, the module is based on recent developments in training around sexuality issues, where the emphasis has moved away from attitude change to training in knowledge and skills.

Within this context, there is no expectation of participants (even in face to face workshops) having to share details of their own sexuality and sexual lives. This change in emphasis is reflected in the structure of the module. The first section is the only section that explicitly addresses the values and background influences of staff, that may affect their approach in dealing with client sexual health concerns. The remainder of the module focuses on increasing staff knowledge and skills in dealing with the sexual concerns of their clients.

Module 6 compiled by:

Grahame Simpson PhD
NHMRC Health Professional Research Fellow
Research Team Leader/Senior Social Worker
Brain Injury Rehabilitation Unit,
Liverpool Hospital, Sydney
and
Ruth Orchison
Clinical Psychologist
Geriatric Rehabilitation Service
Liverpool Hospital, Sydney