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Patchwood E, Foote H, Vail A, Cotterill S, Hill G, Bowen A. Wellbeing After Stroke (WAterS): Feasibility Testing of a Co-developed Acceptance and Commitment Therapy Intervention to Support Psychological Adjustment After Stroke. Clin Rehabil 2024; 38:979-989. [PMID: 38505946 PMCID: PMC11118776 DOI: 10.1177/02692155241239879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/28/2024] [Indexed: 03/21/2024]
Abstract
OBJECTIVE Feasibility test a co-developed intervention based on Acceptance and Commitment Therapy to support psychological adjustment post-stroke, delivered by a workforce with community in-reach. DESIGN Observational feasibility study utilising patient, carer, public involvement. SETTING Online. UK. PARTICIPANTS Stroke survivors with self-reported psychological distress 4 + months post-stroke. INTERVENTIONS The co-developed Wellbeing After Stroke (WAterS) intervention includes: 9-weekly, structured, online, group sessions for stroke survivors, delivered via a training programme to upskill staff without Acceptance and Commitment Therapy experience, under Clinical Psychology supervision. MAIN MEASURES Feasibility of recruitment and retention; data quality from candidate measures; safety. Clinical and demographic information at baseline; patient-reported outcome measures (PROMs) via online surveys (baseline, pre- and post-intervention, 3 and 6 months after intervention end) including Mood (hospital anxiety and depression scale (HADS)), Wellbeing (ONS4), Health-Related Quality of Life (EQ5D5L), Psychological Flexibility (AAQ-ABI) and Values-Based Living (VQ). RESULTS We trained eight staff and recruited 17 stroke survivors with mild-to-moderate cognitive and communication difficulties. 12/17 (71%) joined three intervention groups with 98% attendance and no related adverse events. PROMS data were well-completed. The HADS is a possible future primary outcome (self-reported depression lower on average by 1.3 points: 8.5 pre-group to 7.1 at 3-month follow-up; 95% CI 0.4 to 3.2). CONCLUSION The WAterS intervention warrants further research evaluation. Staff can be trained and upskilled to deliver. It appears safe and feasible to deliver online to groups, and study recruitment and data collection are feasible. Funding has been secured to further develop the intervention, considering implementation and health equality.
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Affiliation(s)
- Emma Patchwood
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of Manchester, Manchester, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Hannah Foote
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of Manchester, Manchester, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Andy Vail
- Division of Population Health, Health Services Research & Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Sarah Cotterill
- Division of Population Health, Health Services Research & Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Geoff Hill
- Neuropsychology Service, South Tees Hospitals NHS Foundation Trust, The James Cook University Hospital, Middlesbrough, UK
| | | | - Audrey Bowen
- Geoffrey Jefferson Brain Research Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of Manchester, Manchester, UK
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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Tsow R, Pollock C, Mehta S, Turcott A, Kang R, Schmidt J. A Look at Traumatic Brain Injury Community Programs in British Columbia: Barriers and facilitators of implementation. Brain Inj 2024; 38:539-549. [PMID: 38465902 DOI: 10.1080/02699052.2024.2327471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 03/04/2024] [Indexed: 03/12/2024]
Abstract
RESEARCH OBJECTIVES 1) Characterize the delivery of programs that support acceptance and resiliency for people with brain injury in the healthcare sector; 2) Understand the barriers and facilitators in implementation of programs to support self-acceptance and resiliency for people with brain injury. DESIGN Participatory focus groups were used to explore experiences of conducting brain injury programs and knowledge of the barriers and facilitators to their implementation. Focus group data were analyzed with manifest content analysis to minimally deviate from broad and structural information provided by participants. SETTING Four focus group sessions were conducted online through a video calling platform. PARTICIPANTS 22 individuals from community associations conducting programs for people with brain injury. Participants were recruited from a public brain injury organization database. RESULTS Systemic challenges such as access to and allocation of funding require navigation support. Resource consistency and availability, including stable program leaders and a welcoming atmosphere, are important for program implementation and sustainability. Shared experiences promote connection with the community and personal development. CONCLUSIONS This study informs individual- and community-level approaches to promote meaningful life after brain injury. Findings highlight existing resources and support future programming for people with brain injury.
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Affiliation(s)
- Rebecca Tsow
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Courtney Pollock
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Swati Mehta
- Parkwood Institute Research, Lawson Health Research Institute, London, ON, Canada
| | - Alyssa Turcott
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Ruthine Kang
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Julia Schmidt
- Rehabilitation Research Program, Centre for Aging SMART, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada a
- Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Sathananthan N, Morris E, Gillanders D, das Nair R, Knox L, Wong D. Rebuilding the self through valued action and group connections after acquired brain injury: Participant perspectives of the VaLiANT group intervention. Neuropsychol Rehabil 2024:1-29. [PMID: 38838171 DOI: 10.1080/09602011.2024.2359992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
Effective interventions that facilitate adjustment following acquired brain injury (ABI) are needed to improve long-term outcomes and meaningful reengagement in life. VaLiANT is an 8-week group intervention that combines cognitive rehabilitation with Acceptance and Commitment therapy to improve valued living, wellbeing, and adjustment. This study explored participant experiences of VaLiANT to optimize its ongoing development. This included characterization of individually meaningful treatment outcomes, mechanisms of action, and intervention acceptability. Qualitative interviews and quantitative ratings were collected from 39 ABI survivors (Mage = 52, SD = 15; 54% stroke) following their participation in VaLiANT. Participants reported diverse outcomes which resulted in three themes being generated following reflexive thematic analysis. "A fuller toolkit for life with brain injury" indicated increased strategy usage and better daily functioning; "The value of connection and belonging" captured the importance of social experiences in shaping recovery; and "Finding the me I can be" represented cognitive, behavioural, and emotional aspects of identity reconstruction post-ABI. The content and delivery of the intervention were rated highly but participants desired greater follow-up and tailoring of the intervention. Overall, VaLiANT appears to facilitate adjustment through several mechanisms, but greater intervention individualization and dosage may be required to enhance the treatment impact.
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Affiliation(s)
- Nick Sathananthan
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Eric Morris
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - David Gillanders
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Roshan das Nair
- Institute of Mental Health, University of Nottingham, Nottingham, UK
- Health Division, SINTEF, Trondheim, Norway
| | - Lucy Knox
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
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Troeung L, Sarunga Raja TL, Mann G, Wagland J, MacLeod C, Martini A. IMproving psYchosocial adjustment to Traumatic Brain Injury from acute to chronic injury through development and evaluation of the myTBI online psychoeducation platform: protocol for a mixed-methods study. BMJ Open 2024; 14:e080030. [PMID: 38508623 PMCID: PMC10953309 DOI: 10.1136/bmjopen-2023-080030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/01/2024] [Indexed: 03/22/2024] Open
Abstract
INTRODUCTION This protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve psychosocial adjustment to TBI across different phases of injury (acute, postacute, and chronic), and (2) undertake an evaluation of efficacy, acceptability, and feasibility. METHODS AND ANALYSIS A three-stage mixed-methods research design will be used. The study will be undertaken across four postacute community-based neurorehabilitation and disability support services in Western Australia. Stage 1 (interviews and surveys) will use consumer-driven qualitative methodology to: (1) understand the recovery experiences and psychosocial challenges of people with TBI over key stages (acute, postacute, and chronic), and (2) identify required areas of psychosocial support to inform the psychoeducation platform development. Stage 2 (development) will use a Delphi expert consensus method to: (1) determine the final psychoeducation modules, and (2) perform acceptance testing of the myTBI platform. Finally, stage 3 (evaluation) will be a randomised stepped-wedge trial to evaluate efficacy, acceptability, and feasibility. Outcomes will be measured at baseline, postintervention, follow-up, and at final discharge from services. Change in outcomes will be analysed using multilevel mixed-effects modelling. Follow-up surveys will be conducted to evaluate acceptability and feasibility. ETHICS AND DISSEMINATION Ethics approval was granted by North Metropolitan Health Service Mental Health Research Ethics and Governance Office (RGS0000005877). Study findings will be relevant to clinicians, researchers, and organisations who are seeking a cost-effective solution to deliver ongoing psychoeducation and support to individuals with TBI across the recovery journey. TRIAL REGISTRATION NUMBER ACTRN12623000990628.
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Affiliation(s)
- Lakkhina Troeung
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Thilaga L Sarunga Raja
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- Oats Street Rehabilitation Centre, Brightwater Care Group, East Victoria Park, Western Australia, Australia
| | - Georgina Mann
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Janet Wagland
- Disability Services, Brightwater Care Group, Inglewood, Western Australia, Australia
| | - Colin MacLeod
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia, Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Inglewood, Western Australia, Australia
- The University of Western Australia, Crawley, Western Australia, Australia
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Morris EMJ, Johns LC, Gaudiano BA. Acceptance and commitment therapy for psychosis: Current status, lingering questions and future directions. Psychol Psychother 2024; 97:41-58. [PMID: 37357973 DOI: 10.1111/papt.12479] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 05/23/2023] [Accepted: 06/05/2023] [Indexed: 06/27/2023]
Abstract
PURPOSE Acceptance and Commitment Therapy for psychosis (ACTp) is a contextual behavioural intervention that promotes psychological flexibility by fostering active acceptance, cognitive defusion, values construction and committed action to enhance well-being and recovery. Multiple studies have shown that ACTp is acceptable and efficacious, but questions remain as to its distinction from similar approaches and the conditions under which it would be implemented most effectively. METHODS We present the current evidence for processes and outcomes of ACTp and summarise the qualitative findings of experiences of service users in ACT programmes. We compare ACTp with other cognitive behavioural therapies and mindfulness-informed interventions for psychosis. RESULTS Acceptance and commitment therapy for psychosis is promising as a pragmatic, process-driven intervention model. Further efforts are needed to investigate psychological flexibility in the context of psychosis with observational, experimental and intervention studies that will inform model scope and treatment refinement. Additionally, implementation research is the necessary next step, including how support persons can be trained in ACTp. Lower intensity and technology-assisted approaches have the potential to reduce barriers to accessing ACTp and extend impact. CONCLUSIONS Over the last 20 years, ACTp has demonstrated meaningful effects in individual and group formats in a range of settings, targeting outcomes such as rehospitalisation, depression, psychotic symptom distress and impact. Future work should focus on how best to integrate ACTp with other current evidence-based interventions for psychosis.
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Affiliation(s)
- Eric M J Morris
- School of Psychology & Public Health, La Trobe University, Melbourne, Victoria, Australia
- Northern Health, Melbourne, Victoria, Australia
| | - Louise C Johns
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Brandon A Gaudiano
- Department of Psychiatry & Human Behavior, Brown University & Butler Hospital, Providence, Rhode Island, USA
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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Fletcher K, Wydera S, Thorpe N, Radford K, das Nair R, Booth V. A rapid realist review of clinical neuropsychology rehabilitation programmes to improve psychological wellbeing and quality of life for people with acquired brain injuries. Neuropsychol Rehabil 2023:1-36. [PMID: 37975854 DOI: 10.1080/09602011.2023.2273580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 10/03/2023] [Indexed: 11/19/2023]
Abstract
Approximately 20% of acquired brain injury (ABI) survivors experience reduced psychological wellbeing (PWB). Neuropsychological rehabilitation (NPR) is one approach supporting people with ABI to participate meaningfully in activities despite challenges. Although literature supports NPR effectiveness, little is known about change mechanisms. This systematic realist review identifies what NPR programmes have been designed, delivered, and evaluated for people with ABI to improve PWB and/or quality of life (QOL), as well as providing a context-relevant understanding of what NPR includes and how NPR might lead to positive outcomes. A rapid realist review was conducted in three phases: (1) structured retrieval and evidence extraction; (2) stakeholder consultation; (3) analysis and synthesis. Searches were completed, and findings from 35 publications and one stakeholder consultation were synthesized into a refined logic model. Six context-mechanism-outcome chains (CMOCs) were identified. Participants' relationships to internal experiences, and feelings of self-worth, mastery, and connection appeared to be mechanisms that led to improved PWB and QOL. Adaptation and individualized programmes were also key mechanisms to explain successful NPR. Embedding CMOCs into NPR could improve PWB and/or QOL for people with ABI. The logic model will inform ongoing development of a new online, group-based, NPR programme.
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Affiliation(s)
- K Fletcher
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
- Midlands Partnership NHS Foundation Trust, Stafford, UK
| | | | - N Thorpe
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
| | - K Radford
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
| | - R das Nair
- Nottinghamshire Healthcare NHS Foundation Trust, Nottingham, UK
- SINTEF, Trondheim, Norway
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - V Booth
- Division of Rehabilitation & Ageing, University of Nottingham, Nottingham, UK
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Miller LR, Divers R, Reed C, Cherry J, Patrick A, Calamia M. Value-consistent rehabilitation is associated with long-term psychological flexibility and quality of life after traumatic brain injury. Neuropsychol Rehabil 2023:1-19. [PMID: 37708399 DOI: 10.1080/09602011.2023.2256964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023]
Abstract
Meaningful steps have been taken toward using holistic approaches in outpatient rehabilitation for traumatic brain injury (TBI) (i.e., treating the whole individual); however, research and practice continue to disproportionately focus on adapting to physical and cognitive changes. Research suggests treatment focusing on individual values may be important for psychological adjustment after TBI. The current study sought to explore individual values across multiple life domains in those with TBI as well as what values outpatient rehabilitation was helpful for, and to examine discrepancies between these factors (i.e., value-consistent rehabilitation) in relation to important long-term treatment outcomes. 215 adults with a history of TBI who had participated in outpatient rehabilitation completed online surveys assessing how consistent outpatient rehabilitation was with individual values, psychological flexibility, and quality of life. The life domains with the greatest discrepancies between individual importance and rehabilitation helpfulness were spirituality, intimate relations, and family relations. Greater value-consistent rehabilitation was associated with higher levels of psychological flexibility and quality of life beyond demographics and injury characteristics. Our findings provide further support in favour of holistic, client-centred approaches that are facilitated by neurological rehabilitation programs.
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Affiliation(s)
- Luke R Miller
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Ross Divers
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Christopher Reed
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Jared Cherry
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
| | - Abihail Patrick
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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Foote H, Bowen A, Cotterill S, Hill G, Pieri M, Patchwood E. A scoping review to identify process and outcome measures used in acceptance and commitment therapy research, with adults with acquired neurological conditions. Clin Rehabil 2022; 37:808-835. [PMID: 36540937 PMCID: PMC10134096 DOI: 10.1177/02692155221144554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Background Acceptance and Commitment Therapy interventions are increasing in use in neurological populations. There is a lack of information on the measures available. Purpose To identify and classify the measures used in Acceptance and Commitment Therapy research studies with adults with acquired neurological conditions. Methods PRISMA-ScR guided scoping review. MEDLINE, PsycInfo and CINAHL databases searched (up to date 29/06/2022) with forward and backward searching. All study types included. Extraction of Acceptance and Commitment Therapy process-of-change and health-related outcome measures. Outcomes coded using the Core Outcome Measures in Effectiveness Trials (COMET) taxonomy. Results Three hundred and thirty three papers found on searching. Fifty four studies included and 136 measurement tools extracted. Conditions included multiple sclerosis, traumatic brain injury and stroke. Thirty-eight studies measured processes of change, with 32 measures extracted. The process measure most often used was the Acceptance and Action Questionnaire ( n = 21 studies). One hundred and four health-related outcome measures extracted. Measures exploring quality of life, health status, anxiety and depression occurred most frequently, and were used in all included neurological conditions. COMET domains most frequently coded were emotional functioning/well-being ( n = 50), physical functioning ( n = 32), role functioning ( n = 22) and psychiatric ( n = 22). Conclusions This study provides a resource to support future identification of candidate measures. This could aid development of a Core Outcome Set to support both research and clinical practice. Further research to identify the most appropriate and relevant targets and tools for use in these populations should include expert consensus, patient, carer and public involvement and psychometric examination of measures.
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Affiliation(s)
- Hannah Foote
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
- Hannah Foote, Geoffrey Jefferson Brain
Research Centre, The Manchester Academic Health Science Centre, Northern Care
Alliance and University of Manchester, Manchester, UK.
| | - Audrey Bowen
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
| | - Sarah Cotterill
- Centre for Biostatistics, University of Manchester, Manchester, UK
| | - Geoff Hill
- South Tees Hospitals NHS Foundation
Trust, The James Cook University Hospital, Middlesbrough, UK
| | | | - Emma Patchwood
- Geoffrey Jefferson Brain Research
Centre, The Manchester Academic Health Science Centre, Northern Care Alliance and University of
Manchester, Manchester, UK
- Division of Neuroscience and
Experimental Psychology, Faculty of Biology, Medicine and Health, University of Manchester,
Manchester, UK
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Sathananthan N, Morris EMJ, Gillanders D, Knox L, Dimech-Betancourt B, Wright BJ, das Nair R, Wong D. Does Integrating Cognitive and Psychological Interventions Enhance Wellbeing After Acquired Brain Injury? Study Protocol for a Phase II Randomized Controlled Trial of the VaLiANT (Valued Living After Neurological Trauma) Group Program. FRONTIERS IN REHABILITATION SCIENCES 2022; 2:815111. [PMID: 36188858 PMCID: PMC9397748 DOI: 10.3389/fresc.2021.815111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/29/2021] [Indexed: 11/13/2022]
Abstract
Background and Objectives Cognitive and emotional changes affect the majority of individuals with acquired brain injury (ABI) and are associated with poorer outcomes. The evidence for “siloed” rehabilitation approaches targeting cognition and mood separately remains mixed. Valued living (i.e., acting consistently with personal values) is associated with better psychological functioning and participation in work and other productive activities. Rehabilitation interventions that concurrently address cognitive and emotional barriers to valued living may therefore result in improved outcomes. VaLiANT (Valued Living After Neurological Trauma) is an 8-week group intervention developed by our team, which uniquely combines cognitive rehabilitation and psychological therapy to improve wellbeing and meaningful participation (i.e., valued living) following ABI. Method This protocol describes the design and implementation of a Phase II parallel-group randomized controlled trial with blinded outcome assessors, to evaluate the potential efficacy of VaLiANT and the feasibility of a Phase III trial. Participants are adults with a history of ABI at least 3 months prior to study entry, who experience cognitive and/or emotional difficulties and associated reduced participation in valued activities. Random allocation to the treatment condition (8-week VaLiANT group program) or a usual care waitlist control condition occurs at a 2:1 treatment: control ratio. The primary outcome is wellbeing, measured by the Warwick-Edinburgh Mental Wellbeing Scale. Secondary outcomes include measures of valued living, mood, cognitive complaints, quality of life, community participation, post-traumatic growth, and self-efficacy. All measures are collected across three time points by blinded assessors (baseline, 8-week follow-up, 16-week follow-up). Trial feasibility will be evaluated against recruitment rates, drop-out rates, intervention acceptability, and treatment fidelity (manual adherence and therapist competence). Discussion This trial will extend current knowledge on how to improve long-term outcomes following ABI by evaluating an innovative integrated, multi-domain approach to rehabilitation concurrently addressing cognitive and emotional barriers to participation in meaningful life roles.
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Affiliation(s)
- Nick Sathananthan
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Eric M. J. Morris
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - David Gillanders
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Lucy Knox
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | | | - Bradley J. Wright
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Roshan das Nair
- Institute of Mental Health, University of Nottingham, Nottingham, United Kingdom
| | - Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- *Correspondence: Dana Wong
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Miller H, Lawson D, Power E, das Nair R, Sathananthan N, Wong D. How do people with acquired brain injury interpret the Valued Living Questionnaire? A cognitive interviewing study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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