Cognitive behavior therapy after acquired brain injury: maintenance of therapeutic benefits at 6 months posttreatment

Abstract

Objectives: To examine whether 6-month posttreatment acquired brain injury (ABI) patients receiving cognitive behavior therapy (CBT) adapted for ABI would demonstrate (1) maintenance of psychological benefits, (2) better community integration, and (3) commensurate benefits for both teletherapy and face-to-face group therapy. A secondary objective was to examine the relationship between coping strategies and mood and community integration.

Participants: Seventeen chronic ABI patients with elevated psychological distress.

Outcome measures: Symptom Checklist-90-Revised (SCL-90-R), Depression Anxiety Stress Scales-21 (DASS-21), Community Integration Questionnaire, and the Ways of Coping questionnaire, revised.

Procedures: Eleven CBT sessions provided either in a face-to-face group format or individually by telephone with outcomes measured pretreatment, posttreatment, and at 6-month follow-up.

Results: At 6-month follow-up, full-group scores were significantly better than pretreatment for psychological distress (t(16) = 6.22, P < .01, SCL-90-R; t(16) = 7.32, P < .01, DASS-21) and for community integration (t(16) = -6.15, P < .01), with negligible decrements from immediately posttreatment. Subgroup scores were comparable. Coping also improved but was uncorrelated with mood or community integration.

Conclusion: The CBT adapted for ABI shows enduring benefits for mood and community integration. The efficacy of teletherapy obviates service access problems related to geographical remoteness and mobility restrictions. A larger, randomized, control trial that examines underlying mechanisms of efficacy is needed.