Article

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.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS