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Let’s talk about cannabis

BIS Services reflect on its successful conference which tackled the topic of cannabis and brain injury

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Natalie Mackenzie, director of BIS Services, reflects on their recent conference which tackled the topic – still often regarded as a taboo subject – of cannabis and its role in supporting brain injury survivors in their ongoing recovery 

 

Myself and the team at BIS Services were immensely proud to deliver our first conference “Let’s Talk about Cannabis” on May 23 at the beautiful venue One Great George Street in Westminster, London. Superbly supported by the great team at ABI Solutions, it was a day of reflection, learning and debate. I heard more than once, “there is such a great buzz in the room”.

Reflecting on the day, we are delighted that we were able to present such a well received program, that allowed many professionals working in the field of community neuro rehab to walk away full of knowledge. There was certainly a great energy in the venue throughout the day and it was a pleasure to see many of our colleagues as well as new faces. 

We provided ourselves the opportunity to delve deep into conversation about what, in the past, has often been a side-lined or taboo matter when working with our complex clients living with acquired brain injury. Having sat in many MDT meetings and supervisory meetings with our cognitive rehabilitation assistants, the challenges of working with clients who have sought to soothe themselves through most often, recreational use of cannabis, is appearing to be more the norm than the exception. The perceived obstacles and barriers posed, can at times seem insurmountable, leaving the individuals supporting clients often pondering the expectations of their own input and realistic outcomes.

The phrases ‘lacking motivation’ ‘disengaged’ and ‘low’ are all too often heard; although spending time reflecting with our clients indicated their perception was quite the opposite. The main message from them was that their rehabilitation actually improved as a result of their cannabis use. Of course, it’s not always that ‘rosy’, but clients reported they were actively able to increase their engagement in rehabilitation provision and felt more in control of their own physical and psychological needs. Is that the cannabis talking, or should we explore that more? The latter was our drive to bring this conference together, with the overall aim to develop a greater understanding of the benefits of cannabis use across the lifespan, as well as insightful strategies when the obstacles present themselves. Feedback indicated we did just that. Some feedback included “Excellent conference, well balanced and put together.  Really interesting and aimed at the right level for the audience.  Thank you!”

“An outstanding event – everything ran to perfection.  Incredibly interesting day and outstanding speakers – look forward to the next event!”

Our team at BIS Services are committed to ensuring that our clients and their families receive a specialist and bespoke service, supported by professionals who truly understand and acknowledge the clients needs and motivations, and can work within less than perfect circumstances, rather than excluding from services. So many of our clients have been refused services due to a lack of understanding of how to work collaboratively within challenging packages. We take these packages on with enthusiasm and commitment to service quality.

During this exciting and innovative conference delegates we were taken through a variety of professional approaches to managing cannabis or addictive behaviours when working with individuals with acquired brain injury in community settings. 

What made me most proud was to see two of our clients, supported by Eky our Operations Director and Pedro, Client Liaison Manager, open the conference with a frank and honest conversation about their cannabis use. Bradley and George provided such insights into their experiences of cannabis use and its impact from a perspective we too often fail to provide in these settings. Lived experience, from the clients we all support is the most powerful and informative. To watch them grow in confidence and spend time networking in a world they confess they often avoid, was a delight to see. Even to hear them tell us that they had no idea those professionals working with them attend such events, to enable us to support them more, gave them further insights into the drive of case managers and multi disciplinary teams have to ensure we can support individuals to the highest standard, in a non judgemental and informed way. Eky and Pedro provided insights into the challenges our rehabilitation assistants face, as well as how we manage from a management perspective, from health and safety requirements to more individualised needs. Everyone thoroughly enjoyed and appreciated their insights and the feedback about their bravery was loud and clear.

“Skills, knowledge and experience of presenters and how this was delivered was excellent, interactive and service users helped to give a good insight”

“Brilliant set up very engaging.  The interactive quiz and client interview section were a great idea.  All felt very ‘real’ – education through context and true stories not just lab studies and hypotheticals”

Professor Mike Barnes explored the history of medicinal cannabis use and current prescription uses in the UK, with his usual confidence and humour, taking us on a deep dive into the need for more specialists in the medical field to come forward and increase prescriptive uses. His expertise in the area is second to none, and it was a privilege to have him contribute to the day. 

“Wow! What a superb presenter – so engaging and knowledgeable”

“Is there anything more captivating than a passionate speaker? Very informative without being overwhelming or difficult to digest. Useful advice re line of use”

Neuropsychological impacts of cannabis use was the first of our psychological insights for the conference, delivered by the highly skilled Dr Penny Trayner, showing her newborn baby how to deliver! Covering the evidence around the short-term and long-term impact of cannabis use on neuropsychological functioning, including impact on cognitive domains such as memory, speed of information processing, executive functioning skills and academic achievement. The signs, symptoms and patterns of problematic cannabis use was discussed, including evidence for psychosocial reasons for starting for commencing and continuing cannabis use amongst children and adolescents, as well as recommendations for intervention where required. Ensuring we covered across age groups was important to us given our audience demographic and for us, the in challenging period of transition from adolescence to adulthood when working with clients with acquired brain injury. Not an easy time generally, so we must improve our toolboxes for this population.

“Very refreshing to have shared with lots of research which does not suggest cannabis users are ‘ruined’ for life. Thought provoking points re cause and effect and testing on intoxicated person if this is their norm”

“An inspirational woman and great speaker.  I learnt so much from the clinical slide which I wouldn’t normally get to learn about in my work”

An important cog in the process that we must consider is the litigation aspect, from engagement in rehabilitation to long term capacity to manage finances, and the impact that cannabis use can have on an ongoing claim. Our sponsors Irwin Mitchell were very supportive of our program, and we were chaired excellently by Laura Martin-Gerard throughout the day. Partner Sarah Griggs and Richard Jervis, Senior Associate took us through relevant case studies to highlight the highs and lows; the complicated relationship between clients and their litigation/deputyship team. Reflections on the need for a highly skilled and committed multi disciplinary teams veined throughout the talk, requiring constant communication and updates to ensure a seamless, although sometimes bumpy, journey. 

“Fascinating insight into the role of COP and the law and clients with these issues which will certainly be beneficial to my own practice”

“Easy to digest despite being a complex topic that could potentially be quite difficult to grasp – very insightful case study to illustrate”

Dr Tomás Campbell & Erika Turner encouraged a collaborative discussion from an MDT approach to learning providing suggestions for adjustments and accommodations to consider in rehabilitation planning whilst working within a family network. The duo addressed the ways in which teams formulate clients’ cannabis use and explore the ways in which a thorough and informed formulation as early as possible assists in understanding cannabis use in the individual’s life. Keep calm and carry on was the mantra, with reflections on the relevant professional experience as to the level of impact that cannabis use may have on ongoing rehabilitation.

“Better understanding of MDT approach and taking into account pre-existing vulnerabilities and formulation into MDT decision making”

“Down to earth and charismatic.  Loved the humanistic approach and the openness towards cannabis problem”

To complete a full lifespan awareness, we were thrilled to present evidence of the role of medical cannabidiol including early life brain injury from a Neurological perspective, delivered eloquently and expertly by Dr Shanika Samarasekera, Neurologist & Clinical Lead for Epilepsy, Queen Elizabeth Hospital Birmingham. Hearing results of research carried out as to the efficacy of Cannabidiol in epilepsy treatment which concluded that such prescriptive use is well-tolerated, is effective in reducing generalised seizures, potentially improves alertness and potentially improves sleep. Strong positive outcomes from case studies further supported the need to engage in further research and delivery of this mode of treatment to improve the lives of individuals managing the impact of epilepsy.

“Excellent talk, was so helpful having case studies that were very balanced – not all having positive outcomes but then to be able to provide understating as to causal factors”

“Very interesting study results.  Explanation of brain scans were great.  NHS perspective amongst a day of primarily private practice speakers was helpful”

Closing the day down with a more ‘chilled’ approach, the psychological formulation in acquired brain injury and working within the Three Circles model presented an opportunity for reflection and case study examples with Dr Fiona Ashworth. Explaining that Compassion Focused Therapy aims to provide clients and clinicians with effective tools to work with challenging circumstances and emotions and involves taking a non-judgemental, empathic approach, she provided focus on clients who are using cannabis as a coping strategy to try to deal with the many challenges they face following brain injury. An MDT shared goal of ’de-shaming’ and a non-judgmental stance is central when supporting clients with ABI in ongoing rehabilitation. 

“A fascinating and insightful talk which has unexpectedly helped me personally as well as professionally.  Thank you Dr Ashworth!”

“Very interesting insight into a possible thought/feeling cycle for clients.  Great ‘behind the scenes’ type look into a clinical psychology journey”

My thanks again to our very supportive sponsors, Irwin Mitchell and to ABI Solutions for making the day run smoothly. It was a pleasure to spend time with many of the delegates at post conference networking where we were joined by BPM rehab, showcasing rehabilitation through the power of music. A mentioned also to a long standing client of BIS Services, James Gardiner, who bravely exhibited his artwork on the day, drawing much attention and admiration. Seeing 3 clients engage so positively in a professional setting, knowing their daily challenges was overwhelming, and I cannot thank them all enough. We must ensure that we hear more from these individuals that we work with day in day out, in these learning settings, which not only allows us to reflect as professionals but more importantly presents us with evidence of the positive outcomes all of our work provides in terms of socialisation, confidence building and insight. Their bravery was commendable and we look forward to developing more skills around these public speaking events. 

If you were unable to attend, the day was recorded and is available for purchase via the ABI Solutions website. For further details on the specialist services BIS Services provide, please visit us at www.thebiss.co.uk 

“I have honestly enjoyed every aspect of the day.  The venue is excellent. The speakers have been informative and interesting.  Thank you”

“Thank you it has been a really interesting and thought provoking day.  Thank you for all the work that has gone in to make it happen.”

“Excellent day from all perspectives – Thank you.  As someone with very limited knowledge of different forms and types of cannabis and CBD.”

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