Article

Although cognitive-behavioural therapy (CBT) is the treatment of choice for
anxiety, its delivery needs to be adapted for individuals with traumatic brain
injury (TBI). It also requires clients' active engagement for maximum benefit.
This study was a pilot randomised controlled trial involving an anxiety treatment
programme adapted for people with TBI, based on CBT and motivational interviewing
(MI). Twenty-seven participants with moderate/severe TBI (aged 21-73 years, 78%
males) recruited from a brain injury rehabilitation hospital were randomly
allocated to receive MI + CBT (n = 9), non-directive counselling (NDC) + CBT (n =
10) and treatment-as-usual (TAU) (n = 8). CBT and MI were manualised and
delivered in 12 weekly individual sessions. Primary outcome was self-reported
anxiety symptoms assessed at baseline, at the end of NDC/MI and immediately
following CBT. Assessment was conducted by assessors blinded to group assignment.
Intention-to-treat analyses showed that the two active treatment groups
demonstrated significantly greater anxiety reduction than TAU. Participants
receiving MI showed greater response to CBT, in terms of reduction in anxiety,
stress and non-productive coping, compared to participants who received NDC. The
results provided preliminary support for the adapted CBT programme, and the
potential utility of MI as treatment prelude. Longer follow-up data are required
to evaluate the maintenance of treatment effects.

Langue : ANGLAIS