Brain damage--Patients--Rehabilitation; Personalized medicine; Sexual orientation; Teenagers--Sexual behavior--United States; Teenagers--United States--Social conditions; Teenagers with mental disabilities


Traumatic brain injuries (TBIs) affect an estimated 1.4 million individuals in the United States annually (Braden et al., 2010), most often affecting those between the ages of 15-19 years (Kerr, Harmon, Marshall, Proescholdbell, & Waller, 2014). Individuals with TBI experience impaired judgment, impulsivity, and a decrease in emotional regulation, which may result in verbal and nonverbal behaviors that negatively impact the development of sexuality and the formation of romantic relationships (Kay & Lezak, 1990). Additionally, people who sustain TBIs as children or adolescents are also faced with challenges of typically developing teens (e.g., impulsivity and undeveloped executive functioning skills), further hindering their ability to develop romantic relationships and sexuality. HeadStrong, a nonprofit organization that provides support services to adolescents and young adults with TBI, expressed a need for a resource to assist in the development of sexuality and romantic relationships for individuals within this population. A self-paced manual was created to provide individuals with TBI between the ages of 14 to 30 with strategies to aid in the development of skills needed for successful engagement in romantic relationships and expression of sexuality. This manual is available through the HeadStrong organization.

First Advisor

Anne Birge James, PhD, OTR/L, FAOTA

Second Advisor

Yvonne Swinth, PhD, OTR/L, FAOTA

Date of Completion

Spring 5-2015

Degree Type







Degree Name

Master of Occupational Therapy (MOT)

Date of Award

Spring 2015


Occupational Therapy


University of Puget Sound