NO, NO, NO! Stroke survivors want 100% recovery! NOT ACCEPTANCE! GET THERE! Will you blithering idiots actually talk to survivors and not provide your tyranny of low expectations. Survivors expect recovery, why don't you provide it?
Acceptance and Commitment Therapy is feasible for people with acquired brain injury: A process evaluation of the BrainACT treatment
Abstract
Objective
To evaluate the feasibility of Acceptance and Commitment Therapy for people with acquired brain injury.
Design
A process evaluation of the BrainACT treatment was conducted alongside a randomised controlled trial.
Setting
Psychology departments of hospitals and rehabilitation centres.
Subjects
Tweny-seven participants with acquired brain injury and 11 therapists.
Intervention
BrainACT
is an Acceptance and Commitment Therapy adapted for the needs and
possible cognitive deficits of people with acquired brain injury,
provided in eight one-hour face-to-face or video-conference sessions.
Measurements
The
attendance and compliance rates, engagement, satisfaction, and
perceived barriers and facilitators for delivery in clinical practice
were investigated using semi-structured interviews with participants and
therapists and therapy logs.
Results
212
of the 216 sessions in total were attended and 534 of the 715 protocol
elements across participants and sessions were delivered. Participants
were motivated and engaged. Participants and therapists were satisfied
with the intervention and participants reported to have implemented
skills in their daily routines acquired during therapy. Key strengths
are the structure provided with the bus of life metaphor, the
experiential nature of the intervention, and the materials and homework.
Participants and therapists often preferred face-to-face sessions,
however, when needed video-conferencing is a good alternative.
Conclusion
BrainACT
is a feasible intervention for people with anxiety and depressive
symptoms following acquired brain injury. However, when the content of
the intervention is too extensive, we recommend adding two extra
sessions.
Introduction
In
this study, we present the outcomes of the process evaluation of the
BrainACT intervention. The process evaluation was conducted alongside a
trial,1
among participants allocated to the Acceptance and Commitment Therapy
arm of this trial. The BrainACT study is a randomised controlled trial
in which the effectiveness of an adapted Acceptance and Commitment
Therapy for anxiety and depressive symptoms following acquired brain
injury is investigated. Next to investigating the effectiveness of an
intervention, it is important to monitor the feasibility, implementation
and delivery of the intervention in a systematic way, as this will
enrich the interpretation of the results.2
In addition, next to quantitative data on effectiveness, process
evaluations, through qualitative data, can provide narratives on
implementation processes, their nuances and the identification of
complex processes, which are not identified with questionnaires.3
Previous
studies have shown the potential effectiveness of Acceptance and
Commitment Therapy for people with brain injury-related mood symptoms.4–6
Acceptance and Commitment Therapy is a third-wave behavioural therapy,
which focuses on the improvement of psychological flexibility. This
entails living in alignment with personal values while accepting
internal processes and being in contact with the present moment.7
We developed the BrainACT intervention, which is a treatment programme
adapted for the needs and possible cognitive deficits of people with
brain injury and investigated its effectiveness in a series of four
single cases.8
Despite promising results in terms of effectiveness, no process
evaluation has been conducted on the feasibility of Acceptance and
Commitment Therapy for people with acquired brain injury.
The
current process evaluation was performed before the analysis of the
effectiveness to avoid bias in the interpretation of results.2
The feasibility of the BrainACT intervention, provided face-to-face as
well as through video-conferencing, was evaluated by: (1) the attendance
(number of sessions attended by participants) and compliance rates
(elements of the protocol delivered by therapists); (2) engagement with
the protocol; (3) satisfaction of participants and therapists; and (4)
barriers and facilitators for delivery in clinical practice as
experienced by both participants and therapists.
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