It is with great pleasure that I write my first Words from the President for the ASSBI newsletter. Before telling you about myself and what makes me tick, I would like to take this opportunity to thank Robyn Tate for her outstanding presidency during the past two years, steering ASSBI through turbulent waters in the past 18 months deftly and with great poise. One recognises a leader not by what they say but by how they react to the uncertainty and the unexpected; And Robyn has been, undoubtedly, a great ASSBI president and I hope to be able to follow her steps. My aim is to continue increasing ASSBI’s visibility in the Australasian landscape as a strong voice for brain injury, regardless of aetiology, and as a platform to promote excellence in applied research and interventions in the field.

At a time when many professional organisations are feeling the continuing impact of the pandemic, with many conferences and meetings cancelled, ASSBI has fared comparatively well. Yes, the 2020 Perth Annual meeting, which is one of the major sources of income for the society, had to be cancelled; however, our online training program and workshops have been very successful by all accounts and minimizing the financial impact of this cancellation on the society. Undoubtedly, this is due in great part to the tireless work of our Executive Officer, Margaret Eagers, together with the Continuing Education Committee, led by Barbra Zupan, which despite these difficulties managed to put together an outstanding program. This year, I am pleased to say that the conference will happen again. Indeed, ASSBI joins forces with the International Neuropsychological Society and the APS College of Clinical Neuropsychologists for what will be a momentous 2021 Annual meeting in Melbourne, with the opportunity to meet face-to-face with your fellow colleagues and friends, as well as remotely.

So, who is our new President? I am currently appointed Professor of Clinical Neuropsychology at the University of Sydney, and director of FRONTIER, the frontotemporal dementia clinical research group based at the Brain & Mind Centre where I lead a research group of ~25 staff/clinicians/postdocs/students investigating early manifestations and progression of younger-onset dementia syndromes. As my name suggests, I am not from around here originally. Native of the land of Jean Piaget and Carl Gustav Jung and, for those following more recent history, Roger Federer. I completed my undergraduate studies in psychology at the University of Geneva. At a time where formal clinical training in neuropsychology was almost non-existent in Europe, I was accepted in the Masters program in Clinical Neuropsychology at the University of Melbourne and was lucky to train under the guidance of Michael Saling, Vicki Anderson, Steve Bowden and, on clinical placements, Anne Unkenstein. Two years of training has turned into a 30-year love story for this country and for neuropsychology, as well as cognitive and clinical neurosciences. In the past 15 years, my focus has been on frontotemporal dementia in its many forms (behavioural variant, language variants, motor presentations). Frontotemporal dementia is a complex disease caused by multiple brain pathologies leading to, sometimes, confusing clinical presentations. Generally emerging in people in their late 50s, it is not uncommonly confused with psychiatric conditions with a long delay to diagnosis and management (Indeed, who wants to think about dementia at that age?). Currently, the major challenges in the field are to improve early and accurate diagnosis and understand disease progression so we can inform patients and families better. My work is varied: In an attempt to reach these goals, I use convergent methodologies, which include behavioural, clinical, cognitive, neuroimaging, physiological, genetics and neuropathological investigations. Obviously, the ultimate aim will be to develop disease modifying treatments and a cure, although the road ahead is still long. In the meantime, we have also been focusing on developing interventions and management programs to address some of the disabling features of these diseases, as well as providing support to carers, families, and education to various scientific organisations and bodies.

I am very excited to start my tenure as ASSBI President. All in all, the society remains very healthy, despite the turbulent recent period. In addition, with difficult times come opportunities: opportunities to reflect on the identity of the society and chances to explore novel options to develop our activities and communicate with our membership and sister societies. I truly believe that the future is bright for ASSBI and I am looking forward to being part of this journey.

Looking forward to seeing you all in Melbourne next month 

Olivier Piguet, President

Our journal Brain Impairment has many new ‘First View’ articles available and our social media editors have been sharing this new high-quality content via our Twitter account @BrainImpairment. They are also busily preparing an #HeadsTogether2021 conference workshop on research dissemination strategy where we will provide an overview of what is possible, how to build engagement, and outline some resources to get you started thinking about how you go about it! Also, don’t forget to check out the new look ASSBI journal webpages here https://assbi.com.au/Journal-BIM and follow the journal @BrainImpairment on Twitter to stay up-to-date.

Many congratulations to Professor  Skye McDonald, who became a proud grandma to a beautiful granddaughter at the end of 2020

Congratulations go to Dr Dana Wong who, at the ASSBI AGM on 6^th May, became President Elect of ASSBI. She takes up this position for 2 years which is followed by 2 years as President and then a further 2 years as Past President.

A serious spinal cord injury in the 90s left Dean bound to his bed. His functions declining over the years, the 51-year-old spent his days eating, sleeping, having a bed bath, changing his urinary bag and watching television. Better Rehab Occupational Therapists Emily and Danielle have been working diligently alongside Dean’s support coordinators and equipment suppliers from AusTech medical to improve his quality of life. They conducted research to explore his options for a power wheelchair (PWC), eventually coordinating a date to trial a chair from Permobil. “The trial took over 3 hours to script the chair to Dean’s anthropometrics, get him on the power wheelchair, check the chair fit within his home, and explore switch options to ensure he could drive the chair,” Emily said.

After an application to the NDIS, funding approval and training, Dean was given his Permobil Power Wheelchair, which he could independently control using ergonomic switches. With his right arm positioned at his chest, he can navigate the PWC forwards and backwards, while head switches facilitate side-to-side movement. A final switch, behind his elbow, allows him to adjust modes, including wheelchair speed and position.

In June, for the first time in 20 years, Dean was able to get out of bed.

“I felt independent and like I was 17 again – driving a car for the first time,” he said. “I felt freedom - like I could go anywhere at any time.”

Emily said Dean has redefined possible and the progress he has made is remarkable.

“When we first met Dean, he was bedbound, only leaving his bed in the ambulance plinth to go to the hospital,” she said. “Dean’s wheelchair is brand new - he has now been able to use it on three occasions in which he was able to spend time in the sun, visit neighbours down his street, see a rainbow, see his backyard for the first time in twenty years and have a tea party on his back patio.” Click here to meet Dean

Better Rehab is an NDIS- registered allied health provider with branches across Australia. For more information on the services they provide, visit www.betterrehab.com.au.

Better Rehab

1300 0 REHAB

www.betterrehab.com.au

As I write my President’s report for the final issue of ASSBI’s Newsletter for the year, I am sure that you will agree with me that we look forward to putting 2020 behind us. Who would have thought that, just 12 months ago, we would experience the worst wildfires in Australia's history burning more than 12.6 million hectares, which would be eclipsed by the COVID-19 pandemic with, at current count, 60.7 million confirmed cases worldwide and 1.4 million deaths.  Australia and New Zealand have continued to be model countries in dealing with the pandemic and, at year’s end, we welcome the reopening of our inter-state and territory borders, and look forward to soon being able to travel within the “Australia-New Zealand bubble”.  Particular mention is made of our Melburnian colleagues, who have recently emerged victorious from a crippling second wave of the virus.  Tough lockdown measures were enforced for more than 110 days, with good community adherence, and a supportive and highly visible Premier who gave lengthy and candid press conferences for 120 consecutive days. We hope that the sky-rocketing rates of infections and deaths in other countries will be contained soon, particularly as the northern hemisphere enters its winter season.

                    Like many other businesses, the pandemic has had adverse consequences upon ASSBI’s financial position.  The annual conference, scheduled for Perth in May, had to be cancelled.  This was a severe financial blow to the Society, given that the conference is our main source of revenue.  But it could have been a lot worse.  Thanks to our remarkable Executive Officer, Margaret Eagers, our Continuing Education Officer, Barbara Zupan, and ASSBI Resources Manager, Skye McDonald, an excellent series of diverse and well-attended webinars was scheduled throughout the remainder of the year.  This was marketed as ASSBI Conference Bite Size, thus allowing ASSBI to continue offering its (always highly acclaimed) professional development programme.  Particular thanks are also due to the webinar speakers, not only for the high standard of their presentations, but also for foregoing payment for the webinars.

                    The ASSBI Committee has been extra busy this year planning for a review of the Society. An important first step in the process was a survey of the membership (see the September 2020 Newsletter for a summary of the survey results).  We have had various working parties to advance this process, and I thank Jacinta Douglas, Olivier Piguet and Dana Wong for working with me to develop the survey items; and also Olivier, Jacinta, Dana, Nicci Grace and Clare Ramsden for their subsequent input into synthesising the results into a detailed report.  This report has been discussed at length by the entire Committee. The next step has been the formation of another Working Party, with Jacinta, Olivier, Jennie Ponsford, Tamara Ownsworth, Janet Wagland, Margaret Eagers and myself, which will take the report and Committee discussions and develop goals for a review for consideration by the Committee.  These activities will carry over into next year and I will keep you updated via the Newsletter.

                    Other activities have included instating a new social media team specifically formed to promote our journal, Brain Impairment (see this Newsletter for details), and student activity, coordinated by Jonathan Reyes.  ASSBI’s encouragement and support of students and early career clinicians and researchers were identified in our membership survey as being worthwhile areas to expand, as is ASSBI’s role in greater inclusion of people with lived experience with brain impairment.  So you can expect to see further development of ASSBI’s role in these areas.

                    As I mentioned in the September Newsletter, one of the most encouraging outcomes of the review was the positive endorsement of ASSBI being a welcoming community that is friendly, approachable, generous, inclusive, supportive, and collegiate; a society where members feel a sense of belonging.  This sets ASSBI aside from many other professional organisations and makes us especially proud of our Society.  I thank both the Committee and the wider membership who make ASSBI what it is.  On that note, I take this opportunity to send you season’s greetings and let us all welcome in 2021 in a big way.

My very best wishes to you all,

Robyn Tate

President 

As the COVID-19 pandemic continues its path of devastation my thoughts go out especially to any ASSBI member who has been personally affected by the pandemic.  The world continues to live with restrictions on everyday living - within Australia our state borders remain closed and international travel is banned.  The second wave has severely affected residents of metropolitan Melbourne who, as I write, are still under lockdown with Stage 4 restrictions, as is regional Victoria with Stage 3 restrictions.  May the situation be vastly improved come my next newsletter later this year.

In the December 2019 Newsletter, I heralded that ASSBI was planning to conduct an external review of the Society – its first review in 43 years of operation.  In preparation for the review, ASSBI conducted an online survey of the membership in May 2020, and here I thank our working party (Jacinta Douglas, Olivier Piguet, and Dana Wong) who worked with me to draw up the survey items, feedback from the Committee, and the suggestions of those who piloted the survey for us.  In this Newsletter, I am highlighting some results from the survey.

The 31-item survey was completed by 100 members (representing 25% of the membership). The overall satisfaction with ASSBI was high (8.45/10, SD=1.41, range 4-10; higher scores reflect higher satisfaction).  Respondents were asked to rate the importance of 16 areas of ASSBI activity, together with their satisfaction.  The table below summarises the findings - the first percentage represents ‘importance’, and the second percentage denotes ‘satisfaction’.  Significant proportions of respondents endorsed the ‘don’t know’ response, especially for ‘satisfaction’ ratings which affect interpretation, and so those percentages are also included.

Survey respondents also provided helpful perspectives on a range of issues, including suggestions about raising ASSBI’s profile and visibility, and ASSBI’s relevance for people with lived experience of brain impairment.  One question regarding the ideal geographical coverage received a wide variety of responses.  Five possible configurations were presented: (i) Australia, New Zealand, neighbouring Pacific Islands and Asia was endorsed by the largest proportion of respondents (41.6%), followed by (ii) Australia, New Zealand, and neighbouring Pacific Islands (28.6%), (iii) Australia and New Zealand (20.8%), (iv) Australia only (6.5%), and (v) other configurations (2.6%).  This information needs to be considered further (including at an AGM) before any recommendation could be made about changing ASSBI coverage.  At present, ASSBI’s geographical coverage applies to Australasia (Australia, New Zealand and neighbouring Pacific islands).

It was gratifying to see that many respondents regard ASSBI as being a welcoming community that was friendly, approachable, generous, inclusive, supportive, and collegiate; a society where members felt a sense of belonging.  ASSBI’s multidisciplinary focus was seen as one of its most attractive features. Overall, the membership survey results suggest that ASSBI is on the right track, but there are areas where we can improve service to our members and the broader community.   Results from the survey have yielded very rich data which the Committee will be considering further and will use not only to inform the external review, but also its forward planning.  I welcome your responses to this brief summary, so please send me your comments.  I will keep you informed, via this Newsletter and the ASSBI website, about next steps regarding the external review.

Table referred to in Robyn's report

Housing for people with high and complex support needs

Since 2006, the Summer Foundation has been working to solve the issue of younger people with disabilities being forced to live in aged care because there is nowhere else for them to live. 

The Summer Foundation’s work includes research into outcomes for people with high and complex support needs – including people with neuro-degenerative conditions and acquired brain injuries – as well as building the capacity of the health and disability sectors to better support people in these cohorts.

Appropriate housing is central to achieving good outcomes for people with high and complex support needs, so in 2017 the Summer Foundation piloted the Housing Hub –www.housinghub.org.au – a website that advertises properties for people with disability.

From small beginnings, the Housing Hub is fast becoming the way for people with disability to find suitable housing. To date, almost 2,300 places to live have been listed on the Hub and around 147,000 people have visited the site. A recently-added feature is the ability for housing seekers to create a Housing Hub profile that details their environmental needs, as well as their preferences around location and property features. If a property is subsequently listed on the Hub that matches a person’s profile, the Housing Hub will notify them directly!

The Summer Foundation’s Housing Hub team also provides a service that supports people with high or complex disability support needs to access appropriate funding from the National Disability Insurance Scheme (NDIS) and connect with suitable housing opportunities.

The Housing Hub team is able to offer support to you with advice, housing resources and connection to appropriate sector professionals at no cost.

For more information phone Melody Carbans on 0499 111 848 or email info@housinghub.org.au

Clinical translation of Cognitive Behavioural Therapy for anxiety and depression - Adapted for Brain Injury (CBT-ABI): How do we train competent clinicians?

Dana Wong, Adam McKay, Nikolaos Kazantzis & Jennie Ponsford
International Journal of Cognitive Therapy
https://link.springer.com/article/10.1007/s41811-020-00079-2

What the study is about
Depression and anxiety are common following acquired brain injury (ABI) and can be effectively treated using cognitive behaviour therapy (CBT) that has been adapted to compensate for cognitive difficulties (CBT-ABI– as outlined in the CBT-ABI manual available from ASSBI Resources!) However, effective delivery of CBT-ABI requires a specialised skill set. Training clinicians to deliver CBT-ABI is therefore a crucial step in effective translation of this intervention into widespread clinical practice.

What we did
This study evaluated the outcome of didactic (instruction-based) and experiential (skill-based) training on competencies in delivering CBT-ABI.  Participants were 39 registered psychologists who attended a day-long ASSBI workshop on using CBT-ABI to treat anxiety and depression after brain injury, which included knowledge-building, observational learning (i.e., videos of CBT-ABI) and skill-based (e.g., role play) content. Fourteen participants completed three additional supervision sessions reviewing audio recordings of their use of CBT-ABI with clients they saw in their workplaces. Training outcomes were measured using surveys rating the usefulness of the various workshop components; a checklist of competencies in CBT-ABI on which participants rated themselves pre- and post-workshop and post-supervision; and the Cognitive Therapy Scale (CTS), used by supervisors and a blinded expert to evaluate supervisees’ skills.

What we found
Participant-rated confidence and competence in delivering CBT-ABI significantly improved following workshop training. Examples of CBT modifications for ABI, case descriptions and videos of CBT-ABI in action were consistently rated as the most helpful elements of the workshop.

Self-rated competencies did not show further change after supervision. CTS ratings of the supervisor, but not the blinded expert, showed significant improvement after short-term supervision. The authors surmised that a longer period of supervision may have been necessary for greater impact on competencies. Nevertheless, at 16-month follow up, self-rated competency gains were maintained; and encouragingly, therapist confidence and competence were no longer major barriers to using CBT-ABI in the workplace. These findings suggest targeted training that includes opportunities for observational and experiential learning is important for clinical translation of this evidence-based intervention.

Acknowledgements
The authors would like to acknowledge and thank the psychologists who participated in the study and the individuals with brain impairment who consented to have their therapy sessions recorded for supervision. We would like to thank Dr Kerrie Haines, who provided supervision for some of the study participants, and Dr Lillian Nejad, who was our expert CTS rater. This research was supported by the Moving Ahead NHMRC Centre of Research Excellence in Brain Recovery.