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Acceptance and Commitment Therapy (ACT) for Psychological Adjustment after Traumatic Brain Injury: Reporting the Protocol for a Randomised Controlled Trial

Published online by Cambridge University Press:  17 January 2013

Diane L. Whiting ,
Grahame K. Simpson ,
Hamish J. McLeod ,
Frank P. Deane  and
Joseph Ciarrochi
Diane L. Whiting*
Affiliation:
Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia School of Psychology, University of Wollongong, Australia
Grahame K. Simpson
Affiliation:
Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney, Australia Rehabilitation Studies Unit, University of Sydney, Australia
Hamish J. McLeod
Affiliation:
Institute of Health and Wellbeing, University of Glasgow, Scotland, UK
Frank P. Deane
Affiliation:
School of Psychology, University of Wollongong, Australia
Joseph Ciarrochi
Affiliation:
School of Social Sciences and Psychology, University of Western Sydney, Australia
*
Address for correspondence: Diane Whiting, Senior Clinical Psychologist, Brain Injury Rehabilitation Unit, Liverpool Hospital. Locked Bag 7103, Liverpool BC NSW 1871, Australia. E-mail: [email protected]
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Abstract

Following a severe traumatic brain injury (TBI) there is a complex presentation of psychological symptoms which may impact on recovery. Validated treatments addressing these symptoms for this group of people are limited. This article reports on the protocol for a single-centre, two-armed, Phase II Randomised Control Trial (RCT) to address the adjustment process following a severe TBI. Participants will be recruited from Liverpool Brain Injury Rehabilitation Unit and randomly allocated to one of two groups, Acceptance and Commitment Therapy (ACT) or an active control (Befriending). The active treatment group utilises the six core processes of ACT with the intention of increasing participation and psychological flexibility and reducing psychological distress. A number of primary and secondary outcome measures, administered at assessment, post-treatment and 1-month follow-up, will be used to assess clinical outcomes. The publication of the protocol before the trial results are available addresses fidelity criterion (intervention design) for RCTs. This ensures transparency in the RCT and that it meets the guidelines according to the CONSORT statement. The protocol has also been registered on the Australian New Zealand Clinical Trials Registry ACTRN12610000851066.

Keywords

Acceptance and Commitment Therapytraumatic brain injurypsychological distressrandomised controlled trialparticipation
Type
Controlled Trials Forum
Information
Brain Impairment , Volume 13 , Issue 3 , December 2012 , pp. 360 - 376
Copyright
Copyright © The Authors 2013

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References

Anson, K., & Ponsford, J. (2006). Evaluation of a coping skills group following traumatic brain injury. Brain Injury, 20 (2), 167–178.CrossRefGoogle ScholarPubMed
Anstey, K.J., Butterworth, P., Jorm, A.F., Christensen, H., Rodgers, B., & Windsor, T.D. (2004). A population survey found an association between self-reports of traumatic brain injury and increased psychiatric symptoms. Journal of Clinical Epidemiology, 57 (11), 1202–1209.CrossRefGoogle ScholarPubMed
Baguley, I.J., Cooper, J., & Felmingham, K. (2006). Aggressive behavior following traumatic brain injury: How common is common? The Journal of Head Trauma Rehabilitation, 21 (1), 45–56.CrossRefGoogle ScholarPubMed
Bendall, S., Jackson, H.J., Killackey, E., Allott, K., Johnson, T., Harrigan, S., . . . McGorry, P.D. (2006). The credibility and acceptability of befriending as a control therapy in a randomized controlled trial of cognitive behaviour therapy for acute first episode psychosis. Behavioural and Cognitive Psychotherapy, 34 (03), 277–291.CrossRefGoogle Scholar
Bendall, S., Killackey, E., Jackson, H., & Gleeson, J. (2003). Befriending manual. Melbourne, Australia: OXYGEN Research Centre.Google Scholar
Bentler, P.M. (2006). EQS 6 structural equations program manual. Encino, CA: Multivariate Software, Inc.Google Scholar
Blanchet, S., Paradis-Giroux, A.A., Pépin, M., & Mckerral, M. (2009). Impact of divided attention during verbal learning in young adults following mild traumatic brain injury. Brain Injury, 23 (2), 111–122.CrossRefGoogle ScholarPubMed
Bond, F.W., Hayes, S.C., Baer, R.A., Carpenter, K.C., Guenole, N., Orcutt, H.K., . . . Zettle, R.D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological flexibility and acceptance. Behavior Therapy, 42, 676–688.CrossRefGoogle Scholar
Borrelli, B. (2011). The assessment, monitoring, and enhancement of treatment fidelity In public health clinical trials. Journal of Public Health Dentistry, 71, S52–S63.CrossRefGoogle ScholarPubMed
Brown, F.J., & Hooper, S. (2009). Acceptance and Commitment Therapy (ACT) with a learning disabled young person experiencing anxious and obsessive thoughts. Journal of Intellectual Disabilities, 13 (3), 195–201.CrossRefGoogle ScholarPubMed
Brown, M., Gordon, W.A., & Spielman, L. (2003). Participation in social and recreational activity in the community by individuals with traumatic brain injury. Rehabilitation Psychology, 48 (4), 266–274.CrossRefGoogle Scholar
Bryant, R.A., Moulds, M., Guthrie, R., & Nixon, R.D.V. (2003). Treating acute stress disorder following mild traumatic brain injury. American Journal of Psychiatry, 160 (3), 585–587.CrossRefGoogle ScholarPubMed
Carney, N., Chesnut, R.M., Maynard, H., Mann, N.C., Patterson, P., & Helfand, M. (1999). Effect of cognitive rehabilitation on outcomes for persons with traumatic brain injury: A systematic review. The Journal of Head Trauma Rehabilitation, 14 (3), 277.CrossRefGoogle ScholarPubMed
Carroll, E., & Coetzer, R. (2011). Identity, grief and self-awareness after traumatic brain injury. Neuropsychological Rehabilitation, 21 (3), 289–305.CrossRefGoogle ScholarPubMed
Cattelani, R., Zettin, M., & Zoccolotti, P. (2010). Rehabilitation treatments for adults with behavioral and psychosocial disorders following acquired brain injury: A systematic review. Neuropsychology Review, 20 (1), 52–85.CrossRefGoogle ScholarPubMed
Chawla, N., & Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review. Journal of Clinical Psychology, 63 (9), 871–890.CrossRefGoogle ScholarPubMed
Chervinsky, A.B., Ommaya, A.K., deJonge, M., Spector, J., Schwab, K., & Salazar, A.M. (1998). Motivation for Traumatic Brain Injury Rehabilitation Questionnaire (MOT-Q): Reliability, factor analysis, and relationship to MMPI-2 variables. Archives of Clinical Neuropsychology, 13 (5), 433–446.CrossRefGoogle ScholarPubMed
Ciarrochi, J., & Bailey, A. (2008). A CBT-practitioner's guide to ACT: How to bridge the gap between cognitive behavioral therapy and acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.Google Scholar
Dahl, J., Wilson, K.G., & Nilsson, A. (2004). Acceptance and Commitment Therapy and the treatment of persons at risk for long-term disability resulting from stress and pain symptoms: A preliminary randomized trial. Behavior Therapy, 35 (4), 785–801.CrossRefGoogle Scholar
deGuise, E., LeBlanc, J., Feyz, M., Meyer, K., Duplantie, J., Thomas, H., . . . Lin, H. (2008). Long-term outcome after severe traumatic brain injury: The McGill interdisciplinary prospective study. The Journal of Head Trauma Rehabilitation, 23 (5), 294–303.CrossRefGoogle ScholarPubMed
Doig, E., Fleming, J., Cornwell, P.L., & Kuipers, P. (2009). Qualitative exploration of a client-centered, goal-directed approach to community-based occupational therapy for adults with traumatic brain injury. The American Journal of Occupational Therapy, 63 (5), 559–568.CrossRefGoogle ScholarPubMed
Draper, K., Ponsford, J., & Schönberger, M. (2007). Psychosocial and emotional outcomes 10 years following traumatic brain injury. The Journal of Head Trauma Rehabilitation, 22 (5), 278.CrossRefGoogle ScholarPubMed
Enders, C.K., & Bandalos, D.L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8 (3), 430–457.CrossRefGoogle Scholar
Fann, J.R., Hart, T., & Schomer, K.G. (2009). Treatment for depression after traumatic brain injury: a systematic review. Journal of Neurotrauma, 26 (12), 2383–2402.CrossRefGoogle ScholarPubMed
Feeley, N., Cossette, S., Cote, J., Heon, M., Stremler, R., Martorella, G., . . . Purden, M. (2009). The importance of piloting an RCT intervention. CJNR (Canadian Journal of Nursing Research), 41 (2), 84–99.Google ScholarPubMed
Fleming, J., Braithwaite, H., Gustafsson, L., Griffin, J., Collier, A.M., & Fletcher, S. (2011). Participation in leisure activities during brain injury rehabilitation. Brain Injury, 25 (9), 806–818.CrossRefGoogle ScholarPubMed
Gregg, J.A., Callaghan, G.M., Hayes, S.C., & Glenn-Lawson, J.L. (2007). Improving diabetes self-management through acceptance, mindfulness, and values: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 75 (2), 336–343.CrossRefGoogle ScholarPubMed
Guillamondegui, O.D., Montgomery, S.A., Phibbs, F.T., McPheeters, M.L., Alexander, P.T., Jerome, R.N., . . . Krishnaswami, S. (2011). Traumatic brain injury and depression. Comparative Effectiveness Review No. 25. Rockville, MD: Vanderbilt Evidence-based Practice Center under Contract No. 290-2007-10065-I.Google ScholarPubMed
Hardy, G.E., Shapiro, D.A., Haynes, C.E., & Rick, J.E. (1999). Validation of the General Health Questionnaire-12: Using a sample of employees from England's health care services. Psychological Assessment, 11 (2), 159–165.CrossRefGoogle Scholar
Hart, P.D.T., Fann, J.R., & Novack, T.A. (2008). The dilemma of the control condition in experience-based cognitive and behavioural treatment research. Neuropsychological Rehabilitation, 18 (1), 1–21.CrossRefGoogle ScholarPubMed
Hayes, S.C., & Strosahl, K.D. (Eds.). (2004). A practical guide to Acceptance and Commitment Therapy. New York: Springer-Verlag.CrossRefGoogle Scholar
Hayes, S.C., Strosahl, K.D., & Wilson, K.G. (2003). Acceptance and commitment therapy: An experiential approach to behavior change. New York: The Guilford Press.Google Scholar
Heled, E., Hoofien, D., Margalit, D., Natovich, R., & Agranov, E. (2012). The Delis–Kaplan Executive Function System Sorting Test as an evaluative tool for executive functions after severe traumatic brain injury: A comparative study. Journal of Clinical and Experimental Neuropsychology, 34 (2), 151–159.CrossRefGoogle ScholarPubMed
Hesser, H., Westin, V., Hayes, S.C., & Andersson, G. (2009). Clients’ in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress. Behaviour Research and Therapy, 47 (6), 523–528.CrossRefGoogle ScholarPubMed
Hibbard, M.R., Rendon, D., Charatz, H., & Kothera, L. (2005). CBT in individuals with traumatic brain injury. In Freeman, S.M. & Freeman, A. (Eds.). Cognitive behavior therapy in nursing practice (pp. 189–220). New York: Springer.Google Scholar
Hibbard, M.R., Uysal, S., Kepler, K., Bogdany, J., & Silver, J. (1998). Axis I psychopathology in individuals with traumatic brain injury. The Journal of Head Trauma Rehabilitation, 13 (4), 24–39.CrossRefGoogle ScholarPubMed
Hodgson, J., McDonald, S., Tate, R., & Gertler, P. (2005). A randomised controlled trial of a cognitive-behavioural therapy program for managing social anxiety after acquired brain injury. Brain Impairment, 6 (3), 169–180.CrossRefGoogle Scholar
Hoffman, S.W., & Harrison, C. (2009). The interaction between psychological health and traumatic brain injury: a neuroscience perspective. The Clinical Neuropsychologist, 23 (8), 1400–1415.CrossRefGoogle ScholarPubMed
Hollis, S., & Campbell, F. (1999). What is meant by intention to treat analysis? Survey of published randomised controlled trials. British Medical Journal, 319 (7211), 670–674.CrossRefGoogle ScholarPubMed
Hsieh, M.Y., Ponsford, J., Wong, D., Schonberger, M., McKay, A., & Haines, K. (2012). A cognitive behaviour therapy (CBT) programme for anxiety following moderate–severe traumatic brain injury (TBI): Two case studies. Brain Injury, 26 (2), 126–138.CrossRefGoogle ScholarPubMed
Hsieh, M.Y., Ponsford, J., Wong, D., Schönberger, M., Taffe, J., & Mckay, A. (2012). Motivational interviewing and cognitive behaviour therapy for anxiety following traumatic brain injury: A pilot randomised controlled trial. Neuropsychological Rehabilitation, 22 (4), 585–608.CrossRefGoogle ScholarPubMed
Kangas, M., & McDonald, S. (2011). Is it time to act? The potential of acceptance and commitment therapy for psychological problems following acquired brain injury. Neuropsychological Rehabilitation, 21 (2), 250–276.CrossRefGoogle ScholarPubMed
Kashdan, T.B., & Rottenberg, J. (2010). Psychological flexibility as a fundamental aspect of health. Clinical Psychology Review, 30 (4), 467–480.CrossRefGoogle ScholarPubMed
Khan-Bourne, N., & Brown, R. (2003). Cognitive behaviour therapy for the treatment of depression in individuals with brain injury. Neuropsychological Rehabilitation, 13 (1-2), 89–107.CrossRefGoogle ScholarPubMed
Kinney, A. (2001). Cognitive therapy and brain-injury: Theoretical and clinical issues. Journal of Contemporary Psychotherapy, 31 (2), 89–102.CrossRefGoogle Scholar
Lovibond, S., & Lovibond, P. (1995). Manual for the depression anxiety stress scales (2nd ed.). Sydney: Psychology Foundation.Google Scholar
McBrinn, J., Wilson, F.C., Caldwell, S., Carton, S., Delargy, M., McCann, J., . . . McGuire, B. (2008). Emotional distress and awareness following acquired brain injury: An exploratory analysis. Brain Injury, 22 (10), 765–772.CrossRefGoogle ScholarPubMed
McDonald, B.C., Flashman, L.A., & Saykin, A.J. (2002). Executive dysfunction following traumatic brain injury: Neural substrates and treatment strategies. NeuroRehabilitation – An Interdisciplinary Journal, 17 (4), 333–344.CrossRefGoogle ScholarPubMed
McKay, C., Wertheimer, J.C., Fichtenberg, N.L., & Casey, J.E. (2008). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): Clinical utility in a traumatic brain injury sample. The Clinical Neuropsychologist, 22 (2), 228–241.CrossRefGoogle Scholar
Mead, N., Lester, H., Chew-Graham, C., Gask, L., & Bower, P. (2010). Effects of befriending on depressive symptoms and distress: systematic review and meta-analysis. The British Journal of Psychiatry, 196 (2), 96–101.CrossRefGoogle ScholarPubMed
Medd, J., & Tate, R. L. (2000). Evaluation of an anger management therapy programme following acquired brain injury: A preliminary study. Neuropsychological Rehabilitation, 10 (2), 185–201.CrossRefGoogle Scholar
Mooney, C.Z., & Duval, R.D. (1993). Bootstrapping: A nonparametric approach to statistical inference. (Sage University paper series on Quantitative Applications in the Social Sciences, series no. 07-095). Newbury Park, CA: Sage.CrossRefGoogle Scholar
Moorey, S., Greer, S., Watson, M., Gorman, C., Rowden, L., Tunmore, R., . . . Bliss, J. (1991). The factor structure and factor stability of the hospital anxiety and depression scale in patients with cancer. The British Journal of Psychiatry, 158 (2), 255–259.CrossRefGoogle ScholarPubMed
Myles, S.M. (2004). Understanding and treating loss of sense of self following brain injury: A behavior analytic approach. International Journal of Psychology and Psychological Therapy, 4 (3), 487–504.Google Scholar
Ownsworth, T., Fleming, J., Shum, D., Kuipers, P., & Strong, J. (2008). Comparison of individual, group and combined intervention formats in a randomized controlled trial for facilitating goal attainment and improving psychosocial function following acquired brain injury. Journal of Rehabilitation Medicine, 40 (2), 81–88.CrossRefGoogle Scholar
Ownsworth, T., Fleming, J., Strong, J., Radel, M., Chan, W., & Clare, L. (2007). Awareness typologies, long-term emotional adjustment and psychosocial outcomes following acquired brain injury. Neuropsychological Rehabilitation, 17 (2), 129–150.CrossRefGoogle ScholarPubMed
Ownsworth, T., Little, T., Turner, B., Hawkes, A., & Shum, D. (2008). Assessing emotional status following acquired brain injury: The clinical potential of the depression, anxiety and stress scales. Brain Injury, 22 (11), 858–869.CrossRefGoogle ScholarPubMed
Ponsford, J., Sloan, S., & Snow, P. (1995). Traumatic brain injury: Rehabilitation for everyday adaptive living. Hillsdale, NJ, England: Lawrence Erlbaum Associates.Google Scholar
Preacher, K.J., & Hayes, A.F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40 (3), 879–891.CrossRefGoogle ScholarPubMed
Randolph, C. (1998). RBANS manual: Repeatable Battery for the Assessment of Neuropsychological Status. San Antonio, TX: The Psychological Corporation.Google Scholar
Rao, V., Rosenberg, P., Bertrand, M., Salehinia, S., Spiro, J., Vaishnavi, S., . . . Brandt, J. (2009). Aggression after traumatic brain injury: Prevalence and correlates. The Journal of Neuropsychiatry and Clinical Neurosciences, 21 (4), 420–429.CrossRefGoogle ScholarPubMed
Ruiz, F.J. (2010). A review of Acceptance and Commitment Therapy (ACT) empirical evidence: Correlational, experimental psychopathology, component and outcome studies. International Journal of Psychology and Psychological Therapy, 10 (1), 125–162.Google Scholar
Russell, W., & Smith, A. (1961). Post-traumatic amnesia in closed head injury. Archives of Neurology, 5 (1), 4–17.CrossRefGoogle ScholarPubMed
Schlund, M.W., & Pace, G. (1999). Relations between traumatic brain injury and the environment: Feedback reduces maladaptive behaviour exhibited by three persons with traumatic brain injury. Brain Injury, 13 (11), 889–897.CrossRefGoogle ScholarPubMed
Schulz, K., Altman, D., & Moher, D. (2010). CONSORT 2010 Statement: Updated guidelines for reporting parallel group randomised trials. British Medical Journal, 340, 698–702.CrossRefGoogle ScholarPubMed
Sherer, M., Boake, C., Levin, E., Silver, B.V., Ringholz, G., & High, W.M. (1998). Characteristics of impaired awareness after traumatic brain injury. Journal of the International Neuropsychological Society, 4 (04), 380–387.CrossRefGoogle ScholarPubMed
Simpson, G.K., Tate, R.L., Whiting, D.L., & Cotter, R.E. (2011). Suicide prevention after traumatic brain injury: A randomized controlled trial of a program for the psychological treatment of hopelessness. The Journal of Head Trauma Rehabilitation, 26 (4), 290–300.CrossRefGoogle ScholarPubMed
Soo, C., & Tate, R. (2009). Psychological treatment for anxiety in people with traumatic brain injury. Cochrane Database of Systematic Reviews, 3. Retrieved from: http://www.thecochranelibrary.com/Google Scholar
Soo, C., Tate, R.L., & Lane-Brown, A. (2011). A systematic review of acceptance and commitment therapy (ACT) for managing anxiety: Applicability for people with acquired brain injury? Brain Impairment, 12 (1), 54–70.CrossRefGoogle Scholar
Sylvester, M. (2011). Acceptance and commitment therapy for improving adaptive functioning in persons with a history of pediatric acquired brain injury. Doctor of Philosophy in Clinical Psychology Dissertation, University of Nevada, Reno.Google Scholar
Tate, R.L., & Douglas, J. (2011). Use of reporting guidelines in scientific writing: PRISMA, CONSORT, STROBE, STARD and other resources. Brain Impairment, 12 (1), 1–21.CrossRefGoogle Scholar
Tate, R.L., Simpson, G.K., Soo, C.A., & Lane-Brown, A.T. (2011). Participation after acquired brain injury: Clinical and psychometric considerations of the Sydney Psychosocial Reintegration Scale (SPRS). Journal of Rehabilitation Medicine, 43 (7), 609–618.CrossRefGoogle ScholarPubMed
Thompson, E.R. (2007). Development and validation of an internationally reliable short-form of the positive and negative affect schedule (PANAS). Journal of Cross-Cultural Psychology, 38 (2), 227–242.CrossRefGoogle Scholar
Veehof, M.M., Oskam, M.J., Schreurs, K.M.G., & Bohlmeijer, E.T. (2011). Acceptance-based interventions for the treatment of chronic pain: A systematic review and meta-analysis. Pain, 152, 533–542.CrossRefGoogle ScholarPubMed
Ware, J.E. Jr, Kosinski, M., & Keller, S.D. (1996). A 12-Item Short-Form Health Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34 (3), 220–233.CrossRefGoogle ScholarPubMed
Watson, D., Clark, L.A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54 (6), 1063–1070.CrossRefGoogle ScholarPubMed
Whitehouse, A.M. (1994). Applications of cognitive therapy with survivors of head injury. Journal of Cognitive Psychotherapy, 8 (2), 141–160.CrossRefGoogle Scholar
Whiting, D., Simpson, G., Ciarrochi, J., & McLeod, H. (2012). Assessing the feasibility of Acceptance and Commitment Therapy in promoting psychological adjustment after severe traumatic brain injury. Brain Injury, 26 (4–5), 588–589.Google Scholar
Whyte, J., & Hart, T. (2003). It's more than a black box; it's a Russian doll: Defining rehabilitation treatments. American Journal of Physical Medicine & Rehabilitation, 82 (8), 639–652.CrossRefGoogle Scholar
Wood, R.L., & Alderman, N. (2011). Applications of operant learning theory to the management of challenging behavior after traumatic brain injury. The Journal of Head Trauma Rehabilitation, 26 (3), 202–211.CrossRefGoogle Scholar
Wright, B.A. (1960). Physical disability - A psychological approach. New York: Harper & Row.CrossRefGoogle Scholar
Ylvisaker, M., Turkstra, L., Coehlo, C., Yorkston, K., Kennedy, M., Sohlberg, M.K.M., . . . Avery, J. (2007). Behavioural interventions for children and adults with behaviour disorders after TBI: A systematic review of the evidence. Brain Injury, 21 (8), 769–805.CrossRefGoogle ScholarPubMed
Zigmond, A. S., & Snaith, R. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67 (6), 361–370.CrossRefGoogle ScholarPubMed