Assessing the feasibility of Acceptance and Commitment Therapy in promoting psychological adjustment after severe traumatic brain injury

This study evaluated the feasibility of a treatment program utilising Acceptance and Commitment Therapy (ACT) to address psychological adjustment to severe traumatic brain injury (TBI). ACT focuses on persons’ relationship with internal experiences such as thoughts, emotions and memories in order for them to live a life consistent with their values. Treatment goals include increasing psychological flexibility, participation in valued life roles and reducing psychological distress. Method: Two participants (both male, P1 aged 20 years, P2 aged 28 years) with severe TBI and demonstrating psychological distress, as measured by the Depression Anxiety and Stress Scale (DASS- 588 Abstract Brain Inj Downloaded from informahealthcare.com by University Of Wollongong on 01/20/13 For personal use only. 21), were recruited from the Brain Injury Rehabilitation Unit, Liverpool Hospital outpatient service. They jointly engaged in a seven session treatment program based on ACT principles. Pre and post-treatment measures of mood, psychological flexibility and participation were undertaken in addition to sessional measures. Statistical analysis involved calculating reliable change for single case study analysis. Results: Both participants demonstrated improvements in their psychological flexibility with P1’s change being significant (P1 RCI¼1.98, P2 RCI¼1.38). They both demonstrated significant decreases in their level of psychological distress (P1 DASS-stress RCI¼ -.2.54, P2 DASS-anxiety RCI¼ -5.11). P2 also reported an increase of 6.9 points on participation, approaching the criterion for significant reliable change (a change of 8 points). Moreover, both participants achieved goals set in accordance with their values. Conclusions: ACT shows initial promise as a suitable therapy to improve psychological flexibility, increase participation and reduce psychological distress among people with severe TBI. Further research needs to assess the program in a controlled trial with a larger sample