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Addressing Cyberscams and Acquired Brain Injury (“I Desperately Need to Know What to Do”): Qualitative Exploration of Clinicians’ and Service Providers’ Perspectives

Kimberly Ann Chew ; Jennie Ponsford ; Kate Rachel Gould (2024) — Journal of Medical Internet Research

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Synopsis

Acquired brain injury can heighten susceptibility to scams due to ongoing cognitive and psychosocial changes following injury. Cyberscams produce financial harm alongside debilitating psychological effects such as shame and mistrust, and can interfere with neurorehabilitation and independence. Despite these consequences, there is a lack of psychological interventions specifically for cyberscam survivors and limited evidence on how current professionals address post-ABI cyberscams. The study sought to understand the perspectives and needs of clinicians and service providers as they support individuals experiencing cyberscams after ABI. Twenty multidisciplinary clinicians and service providers across Australia were recruited through purposive sampling. Data were gathered through semi-structured interviews that explored experiences with post-ABI scam events, vulnerabilities, treatments and their effectiveness, and suggestions for future cybersafety recovery interventions. A reflexive thematic analysis approach was employed to synthesize patterns across participant accounts and to articulate a coherent set of themes reflective of real-world clinical practice. Eight themes emerged, each framed within a biopsychosocial view of scam-related vulnerability and impact. The themes included genuine gaps in awareness rooted in cognitive-executive difficulties; difficulties coping with the sense of loss associated with scams; the need for trust and social connection; pronounced reactions from trusted others; a lack of structured guidance or activities for survivors; ongoing financial stress and challenges to independence; the notion of cyberability or digital capability; and the persuasive tactics used by scammers. These themes informed practical clinical recommendations, stressing the inclusion of psychological and cognitive support, the strengthening of financial literacy and cybersafety skills, the promotion of meaningful social engagement, and the importance of collaboration among families and clinical support teams. Together, the findings point to directions for developing recovery-oriented cybersafety interventions and for guiding service delivery across professional settings involved in post-ABI care.

Identified Gaps

There is limited evidence on how the workforce currently addresses post-ABI cyberscams, and no known psychological treatment for survivors’ psychosocial impacts. The authors identify a need to verify whether the reported “triple-hit” of financial loss, reduced independence, and emotional consequences is unique to ABI or extends to other vulnerable groups. Evidence on CyberAbility’s treatment utility is also insufficient.

Methods

Qualitative Australian study using purposive sampling of 20 multidisciplinary clinicians and service providers experienced with adults with ABI and cybercrime vulnerability. Researchers conducted 25 semistructured interviews, face-to-face or by videoconference, from January 2019 to October 2022. Interviews examined client scam experiences, vulnerabilities, current treatments, and intervention recommendations. Transcripts underwent six-phase reflexive thematic analysis, producing eight biopsychosocial themes.

Limitations

The study drew clinician and service-provider perspectives rather than direct survivor accounts and was limited to 20 participants in Australia. The authors explicitly note that generalizability beyond ABI to other disability and vulnerable cohorts requires examination, and that international experiences need study. Findings are qualitative perceptions of 34 client scam cases, so they do not establish intervention effectiveness or prevalence.

Future Work

Evaluate the utility of CyberAbility for both prevention and treatment; develop and co-design a psychological recovery intervention for people with ABI; examine whether findings generalize beyond ABI to other disability and vulnerable cohorts; and explore international experiences supporting post-cyberscam recovery.

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