Designing the Most Effective Multidisciplinary Team to Support a Person with Traumatic Brain Injury

Designing the Most Effective Multidisciplinary Team to Support a Person with Traumatic Brain Injury

Recovering from a traumatic brain injury (TBI) is rarely straightforward. The effects can be wide-ranging, affecting cognition, behaviour, communication, physical function, emotional wellbeing, and social identity. For this reason, the most successful rehabilitation outcomes are achieved not through isolated interventions, but through the coordinated efforts of a multidisciplinary team (MDT)—each professional contributing unique expertise to address the complex and individualised needs of the person.

A well-designed MDT is not just a collection of clinicians; it is a collaborative, person-centred network working with a shared vision. When carefully constructed and led—often by a neuropsychologist or case manager—this team can provide the holistic, structured, and responsive care that individuals with TBI truly need to recover and thrive.

Understanding the Impact of TBI

Traumatic brain injuries can range from mild concussions to severe and life-altering events. Depending on the nature and severity of the injury, a person may experience:

• Cognitive changes (e.g., memory loss, poor attention, reduced processing speed)
• Emotional and behavioural difficulties (e.g., irritability, anxiety, depression, impulsivity)
• Physical impairments (e.g., mobility issues, coordination problems, fatigue)
• Communication challenges (e.g., word-finding difficulties, reduced social pragmatics)
• Loss of confidence and identity, and disruption of social and vocational roles

Given this breadth of impact, recovery requires a team that addresses the person as a whole—not just their symptoms.

Key Members of an Effective TBI Rehabilitation Team

The makeup of the MDT will vary depending on the individual’s needs, but typically includes the following core professionals:

• Neuropsychologist: Often the clinical lead, responsible for assessing cognitive and emotional changes, supporting psychological adjustment, and guiding the rehabilitation process. Neuropsychologists also play a central role in goal-setting and team coordination.
• Occupational Therapist (OT): Focuses on helping the person regain independence in daily activities, whether at home, in the community, or at work or school. Neuro OTs also support cognitive rehabilitation and fatigue management.
• Speech and Language Therapist (SLT): Assesses and treats communication difficulties, including speech, language processing, and social communication. They may also assist with swallowing issues, if present.
• Physiotherapist: Addresses physical rehabilitation, working to improve strength, balance, mobility, and motor coordination. This is crucial for clients with physical impairments post-injury.
• Case Manager: Ensures that all professionals are working in sync, facilitates communication with external services, and helps manage funding and logistics. The case manager also advocates for the client’s needs across different settings.
• Clinical Psychologist or Psychotherapist: Provides therapeutic support to help with adjustment, mood difficulties, trauma, and identity shifts following the injury.
• Support Workers or Rehabilitation Assistants: Deliver hands-on support in day-to-day life, under the guidance of clinicians, helping to implement strategies and build independence.

Other professionals may include neurologists, educational specialists (for children or young adults), vocational rehabilitation consultants, and social workers.

Hallmarks of a Successful MDT

To be effective, a TBI MDT must not only have the right expertise, but also the right approach. Key features include:

• Collaborative goal-setting with the individual and their family
• Regular communication among team members
• Flexible, responsive planning that evolves with the client’s progress
• Clear leadership to coordinate care and ensure consistency
• Compassionate, person-centred practice that values lived experience alongside clinical knowledge

At The London Neurocognitive Clinic, we specialise in building and leading multidisciplinary teams tailored to the unique needs of individuals recovering from traumatic brain injury. Our neuropsychology-led model ensures that rehabilitation is grounded in a deep understanding of cognitive and emotional function, while integrating the essential skills of allied professionals.

We believe that the best outcomes arise when every aspect of a person’s life is considered—cognition, emotion, function, relationships, and identity. By designing effective, collaborative teams, we help clients move beyond survival and towards meaningful recovery, with the right support in place every step of the way.