Psychology Chartered Case Studies


Robert's story

Before his road traffic accident, Robert lived independently and worked in the agricultural industry often responsible for operating heavy farming machinery. At the age of 21 Robert was a passenger in a car which lost control at high speed resulting in a significant brain injury. Robert had crushed the front of his skull and consequently had an operation to remove part of his frontal lobe. After spending around 8 months in hospital, Robert had to move back in with his parents whilst he started his long rehabilitation journey.

As a result of his injury Robert had a number of difficulties with his executive functioning. Planning activities and budgeting became very challenging tasks as Robert would revert to more impulsive behaviours, for example agreeing to go out with people he barely knew and spending all his money without thinking how he would get home. In addition Robert was unable to pick up on certain social cues, for example detecting sarcasm in someone’s voice or not appreciating how close he was stood to someone. There were also occasions where Robert would be caught staring at people or say things without thinking which could cause offense. All of these factors made Robert very vulnerable, especially when reintegrating with the community.

Psychology Chartered were contacted and asked to provide clinical treatment as part of his rehabilitation plan. Our experienced neuropsychologist worked closely with the client, his family and the case manager in the first instance to help identify goals for Henry to work towards with the help of his support worker. Initial attention was given to supporting Robert socially whilst out in the community and more specifically in empowering him to plan what activities he was going to participate in, how long it would take him to get there and how much they would cost. This work then progressed to designing strategies designed to promote Robert searching for social cues from the environment to assess for risk. For example Robert would be encouraged to process his surroundings and to identify if he felt someone was drunk or behaving aggressively.  Furthermore, Robert or to look for signs that a person was enjoying his company for example maintaining rapport and listening carefully to their tone.

Very quickly Robert began to show great strides in being able to better identify environments and people which could potentially be problematic for him. For example, having walked into a pub one evening, Robert noticed a group of young men in the corner who appeared heavily intoxicated and who was arguing with each other. Robert was able to identify this was a potentially hazardous place to be and asked to leave, something he would not have been able to process 6 months prior.

Psychology chartered have been working with Robert for the last 3 years and in that time have overseen a number of psychological therapeutic interventions, one being empowering Robert to be able to have the confidence to engage appropriately whilst out in the community and join a local pool team.


Alex sustained a severe brain injury as a result of being hit by a car at 30mph as he crossed the road. Three years on Alex is now 25 years old and has been living independently in his own home with the support of a 24/7 care team.

Alex’s case manager, Sarah contacted Psychology Chartered to book a bespoke training event to support the team in managing challenging aspects of Alex’s behaviour. Sarah provided examples of instances where Alex’s moods will seemingly deteriorate drastically without warning and as a result often becomes hostile towards staff. Sarah communicated in the last six weeks two staff members, out of a team of seven, had resigned and she feared more would follow if some form of intervention was not taken to support the staff with strategies on managing these episodes of challenging behaviour.

Before the event, Psychology Chartered’s assistant Paul Walshe spent significant time speaking to member of the care team to find out directly from them examples of behaviours they were describing as challenging and to find out some contextual information around how Alex might present prior to becoming frustrated. This information was then used as case studies for the training day and ensured the content was 100% relevant to this specific care team.

On the day of the training, Dr Maddicks and Paul were able to relate psychological theories and behaviour management strategies directly to “real life” examples provided by the team. The session looked at providing alternative ways to communicate and more specifically prompt Alex to engage in certain activities which would reduce the likelihood of his mood deteriorating. Feedback from the session was very pleasing.

Alex's Story


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