Multidisciplinary Collaboration & Focus on Community Guide Work at Brain Injury Research Center

At TIRR Memorial Hermann’s Brain Injury Research Center (BIRC), Shannon Juengst, PhD, CRC, is spearheading efforts to explore the intersection of science, technology and community interaction in order to provide novel ways of caring for individuals with traumatic brain injuries (TBIs).

For Dr. Juengst, who is a senior scientist and clinical investigator at the BIRC, the journey to this work— and to Houston—was somewhat nontraditional.

“Compared to many researchers, my background is rather unique,” she says. “I have a master’s in rehabilitation counseling, with a specialty in working with people with disabilities. I have always been interested in working with people with cognitive disabilities, brain injuries in particular, but also have a background working with people with numerous other conditions that affect cognition and the brain.”

Such work, Dr. Juengst notes, cemented her interest in the importance of mental health and returning people to work, leisure activities, social relationships and other elements of life that mean the most to them.

Following receipt of her PhD in rehabilitation science from the University of Pittsburgh, Dr. Juengst completed a postdoc fellowship in the university’s physical medicine and rehabilitation department. The work involved an emphasis on neurobiology and biomarkers, a divergence from her counseling work.

“This was very formative, as it gave me an opportunity to start to really interact with researchers and clinicians with different backgrounds, and to start to look at connections that spanned the initial biological effects of TBI all the way through community participation and meaningful activity,” she recalls. “It was a really wide spectrum of work, and provided a great opportunity to learn how to speak different therapeutic languages.”

She adds, “I make this point because one of the things that is a big focus of my work now—and is unique about it—is that everything is very multidisciplinary. Coming together with collaborators from a wide variety of backgrounds and areas of expertise has resulted in impactful, holistic projects, which will eventually help people with TBI the most.”

It was at The University of Texas Southwestern in Dallas, where Dr. Juengst worked for five and a half years, that she met Angelle M. Sander, PhD, the current director and senior scientist of BIRC.

When Dr. Sander was looking to bring a new investigator to the BIRC team in Houston, she reached out. Dr. Juengst began her work with TIRR Memorial Hermann in September 2021, and moved to Houston in June 2022.

“What’s really unique about TIRR Memorial Hermann is the focus on community participation, and staying connected with folks who come through rehab in order to make sure that long-term outcomes are the best for them,” Dr. Juengst notes. “The kinds of connections we have with our patients and the community is really central to the work I do, and is not necessarily typical at all organizations. That was the thing that really drew me to come here: having an opportunity to take the research and really translate it into practice more directly than at some institutions.”

This connection with community and dedication to lifelong care for patients with TBI, which has always been central to the philosophy of TIRR Memorial Hermann, is becoming more broadly accepted in the medical community.

“What sets rehabilitation as a field apart from many of the more medical health care fields is that it’s always been work that’s done in partnership with the people you serve,” Dr. Juengst explains. “There’s been a big shift in medicine to have more of this community involvement, engagement of individuals and their care partners, professional care organizations. In rehab, we have always done this, and are uniquely poised to do so because so much of what we do is in the community already, is already focused on people and function in their daily lives.”

Increased interest in viewing care through such a holistic lens, she adds, is helping to address issues that have been disproportionately affecting people with disabilities for decades.

“We can get individuals to a point where they are taking care of their selfcare and daily functions—that is foundational,” Dr. Juengst says. “But if that’s all we did we wouldn’t be happy.”

Happiness, she adds, depends on building quality of life through relationships, engagement and social connection: things that make people feel like active, contributing members of their communities.

“Dr. Sander and I have so much interest in mental health, community participation, leveraging technology for remote delivery and figuring out how do we do that in a way that focuses on health equity and serving underserved communities,” Dr. Juengst notes.

The team at BIRC is partnering with experts and networks both nationwide and within TIRR Memorial Hermann, such as the Spinal Cord Injury and Disability Research Center.

“We are establishing partnerships which are important in order to take what information is available in other fields and apply it,” Dr. Juengst explains. “This is far better than constantly trying to reinvent the wheel in areas we are not experts in.”

Current projects and grant applications include partnerships aimed at addressing social isolation and loneliness, self-management of health care needs and how electronic problem-solving training can allow programs to scale in order to reach far larger numbers of people in need.

“We’re really trying to take the work we’ve built and the evidence it gives us and look at ways to implement and scale and build partnerships with the community, health care systems, education systems and nonprofit organizations that serve individuals with disabilities,” Dr. Juengst says. “We’ve tested these interventions, and we know they work. The question, then, is how do you get them to people?”

Ultimately, Dr. Juengst’s hope is that the work she is conducting can be used to help individuals with a range of injuries.

“Patients with TBI, spinal cord injury, stroke, they have very different types of injuries with very different physical and cognitive consequences, yet some of the participation and mental health consequences are the same,” she says. “We are interested in what we can do so as to not just treat each population in isolation. If approaches apply to people with different types of injuries, you’ve just covered a large percentage of the rehabilitation population that TIRR Memorial Hermann serves. Then you could look at whether this is something we can provide as part of a rehabilitation system for all rehab patients because we’ve shown that the same thing can benefit all of these different populations—that is the end goal.”