Do we need to know about cyberscams in neurorehabilitation? A cross-sectional scoping survey of Australasian clinicians and service providers

Gould, Kate Rachel ; Carolan, Matthew ; Ponsford, Jennie Louise (2022) — Brain Impairment
DOI: 10.1017/brimp.2022.13
Synopsis

This study investigates whether cyberscams—particularly romance scams—are a clinical issue in neurorehabilitation, focusing on adults with acquired brain injury (ABI). People with ABI often experience cognitive, emotional, and social impairments that may increase their susceptibility to online fraud. Yet little guidance exists for clinicians on prevention or intervention.

The researchers conducted a cross-sectional scoping survey of 101 clinicians and service providers across Australia and New Zealand. Participants included neuropsychologists, occupational therapists, speech pathologists, and case managers. Over half (53.46%) reported working with at least one client with ABI who had been victimized by a cyberscam.

Findings revealed that romance scams were the most common (48% of cases), followed by buying/selling scams and attempts to obtain personal information. Most scams lasted several months (average 5.4 months), often initiated via social media or phone calls. Alarmingly, only 21.6% of clients self-identified the scam, while most cases were detected by clinicians or family members. Clients’ awareness of the fraud was typically very low, with a median of only 41.5%.

Clinicians identified several risk factors for cyberscam victimization in ABI clients:

Cognitive deficits, especially poor insight, planning, and problem-solving.

Social vulnerabilities, including loneliness and desire for companionship.

Psychological traits, such as high trust and agreeableness.

Behavioral tendencies, particularly impulsivity.

Lack of supervision of online or financial activities.

The impacts on clients were substantial. Common outcomes included depression (41%), relationship conflict (31%), self-blame (31%), financial distress (29%), and anxiety (25%). Scams often disrupted rehabilitation, with 35% of clinicians reporting that treatment focus shifted to scam recovery, sometimes prolonging therapy or causing disengagement. Clinicians themselves reported feeling worried, frustrated, and emotionally challenged when supporting scammed clients.

Participants rated their own capacity to address cyberscams as limited, with average scores between “minimal” and “adequate” for knowledge, skills, and confidence. No highly effective prevention or intervention strategies were identified. The most endorsed (but only moderately effective) approaches included supervising computer use, partially limiting financial responsibilities, providing online safety tips, referring to psychology, and promoting social participation (Figure 3, p. 10). Notably, clinicians with firsthand experience rated these strategies as less effective than those without.

The authors conclude that cyberscams are a relevant and pressing issue in neurorehabilitation, especially romance scams linked to loneliness and executive impairments. Current interventions are insufficient, and clinicians need better training, tools, and evidence-based resources to help ABI clients prevent, disengage from, and recover from scams. The study calls for further prevalence studies, validated screening tools, and tailored prevention programs that account for cognitive vulnerabilities.
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