A video intervention to improve treatment motivation and self-awareness in people with moderate to severe acquired brain injury (ABI): a feasibility study

Background: Individuals who suffer acquired brain injury (ABI) commonly demonstrate deficits in awareness. This may contribute to poor motivation for participation in neurorehabilitation, as a result of problems with self-regulation, goal-setting, and risk awareness. Research has suggested that preparing individuals for therapeutic interventions can improve engagement and promote more accurate expectations of interventions. For example, recent evidence suggests that providing structured information about treatment rationale and therapy tasks can increase treatment engagement motivation (Campbell et al. 2017). Objectives: To determine feasibility of providing a video of preparatory information within ABI inpatient services, and to investigate the use of this video in increasing insight, motivation, and rehabilitation behaviour (attendance and engagement). Method: Participants (N=11) were recruited from a brain injury inpatient unit, and randomised to immediate or lagged exposure to the video. A preparatory video aimed at improving insight and increasing motivation was shown regularly over a period of four weeks. Multi-disciplinary clinical staff evaluated the feasibility of delivering the video intervention using structured ratings Additionally, pre- and post-trial measures of motivation for rehabilitation, insight and rehabilitation behaviours were recorded. Results: Staff rated the use of the video as feasible, in terms of the intervention itself, resource consequences, and evaluation. In addition, management and senior staff reported intent to continue use of the video. Preliminary exploration of secondary measures of motivation, awareness of deficits, and rehabilitation behaviour suggests there were some indicators of change at individual levels. Due to the main study focus on feasibility, these clinical effects are to be treated as highly preliminary. Conclusions: Further piloting of this preparatory information video intervention is recommended to further explore the effects of such intervention on the motivation and awareness of deficits in people with ABI. There is a need for future trials to include formal process evaluation