Abstract
Objective
To compare the efficacy of 2 group treatments for persons with brain injury (BI) and
their caregivers in promoting perceived self-efficacy (PSE) and emotional and neurobehavioral
functioning.
Design
Randomized controlled trial.
Setting
Outpatient BI rehabilitation.
Participants
Subjects (N=38), including 19 with BI and 19 caregivers, participated in a BI coping
skills group or a support group.
Interventions
BI coping skills is a manualized cognitive-behavioral treatment (CBT). CBT was compared
with a structurally equivalent support group.
Main Outcome Measures
Brain Injury Coping Skills Questionnaire (PSE), Brief Symptom Inventory-18 ([BSI-18];
emotional distress), and Frontal Systems Behavior Scale (neurobehavioral functions).
Results
There were no significant differences between survivors and caregivers on the Brain
Injury Coping Skills Questionnaire and BSI-18; therefore, groups were combined during
final analyses. Frontal Systems Behavior Scale caregiver data were used for analysis.
Both groups showed significantly improved PSE between baseline and follow-up on repeated-measures
analysis of variance, with the CBT group showing greater stabilization of change.
There was no significant group by time interaction on measures of neurobehavioral
functions, but the CBT group showed significant improvements at 3-month follow-up.
No significant effects were found on the BSI-18.
Conclusions
To our knowledge, no studies to date have been published comparing a CBT intervention
with a support group in a BI population with caregiver participation. This study showed
that given equivalent group structure, individuals with BI and caregivers may benefit
from either type of intervention in enhancing PSE or maintaining emotional stability.
However, there was a trend for individuals who received CBT to maintain the effects
of improved PSE, whereas support group participants showed a trend for decline. This
study offers a new conceptualization that with certain group dynamics and support,
individuals with BI and caregivers may benefit similarly from either a support group
or CBT intervention. However, because our sample did not include individuals in clinically
significant emotional distress, we cannot rule out the possibility that those with
more significant challenges in PSE or emotional functions may show greater benefits
with a CBT group.
Keywords
List of abbreviations:
BI (brain injury), BSI-18 (Brief Symptom Inventory-18), CBT (cognitive-behavioral therapy), CI (confidence interval), FrSBe (Frontal Systems Behavioral Scale), PSE (perceived self-efficacy), TAU (treatment-as-usual)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 06, 2015
Footnotes
Supported by the Indiana Spinal Cord and Traumatic Brain Injury Research Fund and the Dr. Lisa Thompson Center for Family Education Fund, Rehabilitation Hospital of Indiana Foundation.
Disclosures: none.
Identification
Copyright
© 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.