Metaphoric identity mapping: Facilitating goal setting and engagement in rehabilitation after traumatic brain injury
Abstract
Difficulty re-establishing an organised and compelling sense of personal identity has increasingly been identified as a critical theme in outcome studies of individuals with severe traumatic brain injury (TBI) and a serious obstacle to active engagement in rehabilitation. There exists little empirical support for approaches to identity reconstruction that address common impairments associated with TBI. Similarly, there is as yet little empirical support for theoretically sound approaches to promoting engagement in goal setting for this population. This article has two purposes. First, theory and procedures associated with metaphoric identity mapping are discussed in relation to goal setting in TBI rehabilitation. Second, the results of a qualitative pilot study are presented. The study explored metaphoric identity mapping as a facilitator of personally meaningful goal setting with five individuals with significant disability many years after their injury. Drawing on principles of grounded theory, the investigators extracted data from semi-structured interviews with clients and clinicians, from focus groups with the clinicians, and from observation of client-clinician interaction. Analysis of the data yielded five general themes concerning the use of this approach: All clients and clinicians found identity mapping to be an acceptable process and also useful for deriving meaningful rehabilitation goals. Both clients and clinicians saw client-centred goals as important. Cognitive impairments posed obstacles to this goal-setting intervention and mandated creative compensations. And finally, identity-related goal setting appeared to require a "mind shift" for some clinicians and demanded clinical skills not uniformly distributed among rehabilitation professionals.
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Metaphors have been proven useful in other therapies for people with acquired brain injury, such as metaphoric identity mapping.
“Metaphors have been proven useful in other therapies for people with acquired brain injury, such as metaphoric identity mapping. 42”
From Acceptance and commitment therapy for people with acquired brain injury: Rationale and description of the BrainACT treatment. (2023) · cites this paper as [42]
Cites
(1998) · Sage eBooks · Cited by 38,631 · see citing works
The "what" and "why" of goal pursuits: Human needs and the self-determination of behavior
Deci, E. L., & Ryan, R. M. (2000) · Psychological Inquiry · doi:10.1207/s15327965pli1104_01 · Cited by 34,210 · see citing works
Ryan, R. M., & Deci, E. L. (2000) · American Psychologist · doi:10.1037//0003-066x.55.1.68 · Cited by 27,815 · see citing works
Handbook of Qualitative Research
Crozier, G., Denzin, N., & Lincoln, Y. (1994) · British Journal of Educational Studies · doi:10.2307/3121684 · Cited by 26,636 · see citing works
Lakoff, G. P., & Johnson, M. L. (2003) · University of Chicago Press eBooks · doi:10.7208/chicago/9780226470993.001.0001 · Cited by 25,252 · see citing works
(1990) · Cited by 24,217 · see citing works
Qualitative evaluation and research methods
Ellis, D. J. (1990) · International Journal of Information Management · doi:10.1016/0268-4012(90)90041-p · Cited by 17,942 · see citing works
ASSESSMENT OF COMA AND IMPAIRED CONSCIOUSNESS
Teasdale, G., & Jennett, B. (1974) · The Lancet · doi:10.1016/s0140-6736(74)91639-0 · Cited by 13,215 · see citing works
Philosophy in the flesh: the embodied mind and its challenge to Western thought
VEREZA, S. C. (1999) · Choice Reviews Online · doi:10.5860/choice.37-0239 · Cited by 9,867 · see citing works
Handbook of qualitative research
Griffin, T. F. (1999) · Psychology and Marketing · doi:10.1002/(sici)1520-6793(199907)16:4 · Cited by 9,061 · see citing works
Qualitative research in health care: Analysing qualitative data
Pope, C. (2000) · BMJ · doi:10.1136/bmj.320.7227.114 · Cited by 8,131 · see citing works
(1990) · Medical Entomology and Zoology · Cited by 5,835 · see citing works
Markus, H., & Nurius, P. (1986) · American Psychologist · doi:10.1037/0003-066x.41.9.954 · Cited by 5,806 · see citing works
A Theory of Goal Setting and Task Performance
Tosi, H. L., Locke, E. A., & Latham, G. P. (1991) · Academy of Management Review · doi:10.2307/258875 · Cited by 4,840 · see citing works
Tosi, H. L. (1991) · Academy of Management Review · doi:10.5465/amr.1991.4278976 · Cited by 4,147 · see citing works
Enhancing the quality and credibility of qualitative analysis.
(1999) · PubMed Central · Cited by 4,133 · see citing works
On the Self-Regulation of Behavior
Carver, C. S., & Scheier, M. F. (1998) · Cambridge University Press eBooks · doi:10.1017/cbo9781139174794 · Cited by 4,110 · see citing works
Qualitative research in health care: Assessing quality in qualitative research
Mays, N. (2000) · BMJ · doi:10.1136/bmj.320.7226.50 · Cited by 3,742 · see citing works
Handbook of self-regulation: research, theory, and applications
(2005) · Choice Reviews Online · doi:10.5860/choice.42-3719 · Cited by 3,644 · see citing works
On the Self-Regulation of Behavior
Wright, B. R. E., Carver, C. S., & Scheier, M. F. (2000) · Contemporary Sociology A Journal of Reviews · doi:10.2307/2654424 · Cited by 3,327 · see citing works
The Dynamic Self-Concept: A Social Psychological Perspective
Markus, H., & Wurf, E. (1987) · Annual Review of Psychology · doi:10.1146/annurev.ps.38.020187.001503 · Cited by 3,089 · see citing works
WILSON, J. T. L., PETTIGREW, L. E. L., & TEASDALE, G. M. (1998) · Journal of Neurotrauma · doi:10.1089/neu.1998.15.573 · Cited by 2,386 · see citing works
Kiresuk, T. J., & Sherman, R. E. (1968) · Community Mental Health Journal · doi:10.1007/bf01530764 · Cited by 1,965 · see citing works
Principles of Frontal Lobe Function
Stuss, D. T. (2002) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195134971.001.0001 · Cited by 1,708 · see citing works
Making stories: law, literature, life
Bruner, J. S. (2003) · HAL · Cited by 1,702 · see citing works
(2018) · فصلنامه علمی پژوهشی توانبخشی · doi:10.32598/rj · Cited by 1,454 · see citing works
Qualitative Research in Health Care
Pope, C., & Mays, N. 1. (2019) · Wiley eBooks · doi:10.1002/9781119410867 · Cited by 1,117 · see citing works
Progress in the psychology of language
Ellis, A. W. (1985) · Lawrence Erlbaum Associates eBooks · Cited by 1,079 · see citing works
The dialogical self: Beyond individualism and rationalism.
Hermans, H. J. M., Kempen, H. J. G., & van Loon, R. (1992) · American Psychologist · doi:10.1037/0003-066x.47.1.23 · Cited by 932 · see citing works
The Stuff of Thought: Language as a Window into Human Nature
(2008) · Library Review · doi:10.1108/00242530810865529 · Cited by 882 · see citing works
The stuff of thought: language as a window into human nature
(2008) · Choice Reviews Online · doi:10.5860/choice.45-6468 · Cited by 852 · see citing works
Suarez-Almazor, M. E., & Kaul, P. (1999) · Current Opinion in Rheumatology · doi:10.1097/00002281-199903000-00005 · Cited by 589 · see citing works
Affect, cognition, and change: re-modelling depressive thought
(1994) · Choice Reviews Online · doi:10.5860/choice.31-6325 · Cited by 434 · see citing works
Theoretical aspects of goal-setting and motivation in rehabilitation
Siegert, R. J., & Taylor, W. J. (2003) · Disability and Rehabilitation · doi:10.1080/09638280410001644932 · Cited by 301 · see citing works
Maclean, N., & Pound, P. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(99)00334-2 · Cited by 294 · see citing works
Qualitative Research in Health Care
Alderson, P. (1996) · BMJ · doi:10.1136/bmj.312.7029.519a · Cited by 294 · see citing works
Is goal planning in rehabilitation effective? A systematic review
Levack, W., Taylor, K. D., Siegert, R. J., Dean, S. G., McPherson, K. M., & Weatherall, M. (2006) · Clinical Rehabilitation · doi:10.1177/0269215506070791 · Cited by 223 · see citing works
Self-citation“Loss of self” in the narratives of people with traumatic brain injuries: A qualitative analysis
Nochi, M. (1998) · Social Science & Medicine · doi:10.1016/s0277-9536(97)00211-6 · Cited by 219 · see citing works
Reconstructing self-narratives in coping with traumatic brain injury
Nochi, M. (2000) · Social Science & Medicine · doi:10.1016/s0277-9536(00)00111-8 · Cited by 200 · see citing works
Spirituality Unplugged: A Review of Commonalities and Contentions, and a Resolution
Unruh, A. M., Versnel, J., & Kerr, N. (2002) · Canadian Journal of Occupational Therapy · doi:10.1177/000841740206900101 · Cited by 168 · see citing works
Bruner, Jerome. (2002). Making stories. Law, literature, life. Farrar, Strauss and Giroux. New York.
González, J. M. (2003) · Athenea Digital Revista de pensamiento e investigación social · doi:10.5565/rev/athenead/v1n3.74 · Cited by 167 · see citing works
Fitzsimons, G. M., & Bargh, J. A. (2004) · Dialnet (Universidad de la Rioja) · Cited by 150 · see citing works
Siegert, R. J., McPherson, K. M., & Taylor, W. J. (2004) · Disability and Rehabilitation · doi:10.1080/09638280410001724834 · Cited by 134 · see citing works
Self-citationReflections on: “So… What Do You Do?” Occupation and the Construction of Identity
Unruh, A. M. (2004) · Canadian Journal of Occupational Therapy · doi:10.1177/000841740407100508 · Cited by 132 · see citing works
The transformation of meaning in psychological therapies
Treasure, J. L. (1998) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(98)00005-9 · Cited by 131 · see citing works
Reconstruction of Identity After Brain Injury
Ylvisaker, M., & Feeney, T. J. (2000) · Brain Impairment · doi:10.1375/brim.1.1.12 · Cited by 127 · see citing works
Self-citationPurposes and mechanisms of goal planning in rehabilitation: The need for a critical distinction
Levack, W., Dean, S. G., Siegert, R. J., & McPherson, K. M. (2005) · Disability and Rehabilitation · doi:10.1080/09638280500265961 · Cited by 125 · see citing works
Self-citationSome observations on the organization of personality.
Rogers, C. R. (1947) · American Psychologist · doi:10.1037/h0060883 · Cited by 124 · see citing works
Memory, Consciousness and the Brain
Tulving, E. (2013) · Psychology Press eBooks · doi:10.4324/9780203782866 · Cited by 121 · see citing works
Some observations on the organization of personality (1947).
Rogers, C. R. (1997) · American Psychological Association eBooks · doi:10.1037/10254-001 · Cited by 120 · see citing works
The Structured Event Complex and the Human Prefrontal Cortex
Grafman, J. H. (2002) · Oxford University Press eBooks · doi:10.1093/acprof:oso/9780195134971.003.0019 · Cited by 118 · see citing works
Occupational Adaptation: Perspectives of People with Traumatic Brain Injury
Klinger, L. (2005) · Journal of Occupational Science · doi:10.1080/14427591.2005.9686543 · Cited by 112 · see citing works
Evidence relating to goal planning in rehabilitation
Wade, D. T. (1998) · Clinical Rehabilitation · doi:10.1191/026921598678166365 · Cited by 102 · see citing works
Helping construct desirable identities: A self-presentational view of psychotherapy.
Kelly, A. E. (2000) · Psychological Bulletin · doi:10.1037/0033-2909.126.4.475 · Cited by 99 · see citing works
Ventral frontal contribution to self-regulation: Convergence of episodic memory and inhibition
Levine, B., Freedman, M., DAWSON, D. R., Black, S. E., & Stuss, D. T. (1999) · Neurocase · doi:10.1080/13554799908402731 · Cited by 86 · see citing works
Self-regulation and Goal Theories in Brain Injury Rehabilitation
Hart, T., & Evans, J. J. (2006) · Journal of Head Trauma Rehabilitation · doi:10.1097/00001199-200603000-00007 · Cited by 83 · see citing works
Self-concept and quality of life following aquired brain injury: A pilot investigation
Vickery, C. D., Gontkovsky, S. T., & Caroselli, J. S. (2005) · Brain Injury · doi:10.1080/02699050400005218 · Cited by 83 · see citing works
Goal orientation and emotional well-being: Linking goals and affect through the self.
Emmons, R. A., & Kaiser, H. A. (1996) · Cited by 77 · see citing works
Judd, D., & Wilson, S. L. (2005) · Brain Injury · doi:10.1080/02699050400010994 · Cited by 75 · see citing works
The Meaning of Work After Acquired Brain Injury
Johansson, U., & Tham, K. (2006) · American Journal of Occupational Therapy · doi:10.5014/ajot.60.1.60 · Cited by 72 · see citing works
Living with arthritis—what is important?
McPherson, P. B. K. M. (2001) · Disability and Rehabilitation · doi:10.1080/09638280110049919 · Cited by 65 · see citing works
Metaphor and Meaning in a Clinical Interview
Mallinson, T., Kielhofner, G., & Mattingly, C. (1996) · American Journal of Occupational Therapy · doi:10.5014/ajot.50.5.338 · Cited by 56 · see citing works
Nippold, M. A. (1998) · Cited by 54 · see citing works
Petrella, L., McColl, M. A., Krupa, T. M., & Johnston, J. (2005) · Brain Injury · doi:10.1080/02699050410001671874 · Cited by 48 · see citing works
Awareness of disability after acquired brain injury and the family context
Yeates, G., Henwood, K. L., Gracey, F., & Evans, J. J. (2007) · Neuropsychological Rehabilitation · doi:10.1080/09602010600696423 · Cited by 45 · see citing works
Consequences of stroke, arthritis and chronic pain—are there important similarities?
McPherson, K. M., Brander, P., Taylor, W. J., & McNaughton, H. (2004) · Disability and Rehabilitation · doi:10.1080/09638280410001702414 · Cited by 44 · see citing works
Self-citationThe New Handbook of Cognitive Therapy Techniques
Stubblefield, C. (2000) · Journal of Psychosocial Nursing and Mental Health Services · doi:10.3928/0279-3695-20001101-16 · Cited by 43 · see citing works
Levack, W., Dean, S. G., McPherson, K. M., et al. (2006) · Brain Injury · doi:10.1080/02699050601118422 · Cited by 36 · see citing works
Self-citationYlvisaker, M., Feeney, T. J., & Capo, M. (2007) · Brain Impairment · doi:10.1375/brim.8.3.276 · Cited by 35 · see citing works
Self-citationThe New Handbook of Cognitive Therapy Techniques
McMullin, R. E. (1999) · Cited by 34 · see citing works
The transformation of meaning: The Interacting Cognitive Subsystems approach.
Teasdale, J. D. (1997) · Cited by 33 · see citing works
Boosting students' capacity to promote their own learning: a goal theory perspective
Boekaerts, M. (1998) · Learning and Instruction · doi:10.1016/s0959-4752(98)00008-5 · Cited by 23 · see citing works
The construction of identity during group therapy among adults with traumatic brain injury
Kovarsky, D., Shaw, A. D., & Adingono-Smith, M. (2007) · Communications · doi:10.1515/cam.2007.029 · Cited by 22 · see citing works
Rebuilding Identity Through Narrative Following Traumatic Brain Injury
Morris, S. D. (2004) · Cited by 20 · see citing works
Ego‐identity: Can it be reconstituted after a brain injury?
Biderman, D. J., Daniels-Zide, E., Reyes, A., et al. (2006) · International Journal of Psychology · doi:10.1080/00207590500345963 · Cited by 17 · see citing works
Traumatic brain injury: a view from the inside
Hill, H. (1999) · Brain Injury · doi:10.1080/026990599121043 · Cited by 17 · see citing works
Awareness of deficit after brain injury: Theoretical and clinical aspects
Prigatano, G. P., & Schacter, D. L. (1991) · Cited by 12 · see citing works
Neurological Substrates of Personal Identity: Implications for Neurorehabilitation
Perna, R. B., & Errico, A. E. (2004) · Cited by 3 · see citing works
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Kangas, M., & McDonald, S. (2011) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2010.540920 · Cited by 133 · see citing works
Herbert, M. S., Afari, N., Robinson, J. B., Listvinsky, A., Bondi, M. W., & Wetherell, J. L. (2018) · The Journal of Pain · doi:10.1016/j.jpain.2018.02.008 · Cited by 15 · see citing works
Rauwenhoff, J. C., Bol, Y., van Heugten, C. M., Batink, T., Geusgens, C. A., van den Hout, A. J., Smits, P., Verwegen, C. R., Visser, A., & Peeters, F. (2023) · Clinical Rehabilitation · doi:10.1177/02692155231154124 · Cited by 15 · see citing works
“Metaphors have been proven useful in other therapies for people with acquired brain injury, such as metaphoric identity mapping.(42) Nevertheless, previous studies have shown that people with acquired brain injury can have difficulties with figurative speech.”
Background
- Authors
- Ylvisaker, M., Mcpherson, K., Kayes, N., & Pellett, E.
- Affiliations
- College of Saint Rose (US)
- Auckland University of Technology (NZ)
- Corresponding author
- Ylvisaker, Mark
- Venue
- Neuropsychological Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2008-11
- Volume
- 18
- Issue
- 5-6
- Pages
- 713-741
- ISSN
- 0960-2011 (ISSN-L)
- 1464-0694
- OpenAlex
- W2076606641
- Cited by
- 147
- References
- 78
- Citations by year
- 2026: 3 · 2025: 12 · 2024: 8 · 2023: 12 · 2022: 13 · 2021: 7 · 2020: 10 · 2019: 9 · 2018: 5 · 2017: 12 · 2016: 3 · 2015: 12 · 2014: 11 · 2013: 5 · 2012: 5
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neuropsychological Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Functions and Memory
- Keywords
- traumatic brain injury, identity reconstruction, goal setting, rehabilitation engagement, cognitive impairment, compensatory strategies, long-term disability
- MeSH terms
- Adult, Aged, Brain Injuries, Female, Goals, Persons with Disabilities, Humans, Interpersonal Relations, Male, Middle Aged, Self Concept, Social Adjustment, Focus Groups
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