Article

Many patients with mild traumatic brain injury do not fully return to
work owing to persistent posttraumatic complaints. Research suggests that
preventing chronic complaints might be prevented by giving cognitive behavioral
therapy early after injury. Therefore, a new cognitive behavioral intervention
(UPFRONT-intervention) was developed to not only prevent chronic complaints but
to also establish a more successful return to work.
The intervention is currently
being evaluated in a multicenter randomized controlled trial design (trial number
ISRCTN86191894) in mild traumatic brain injury patients who are at-risk of
negative outcomes (patients with high numbers of early complaints). Two case
examples are presented to demonstrate the application of the intervention.
RATIONALE: Psychological factors, like cognitive appraisal and coping, play an
important role in the persistence of posttraumatic complaints. Some patients are
less able to adapt and thus to cope with the injury and its initial consequences
than others. Dealing with the injury in a passive, avoidant way, focusing on
negative feelings, will hamper recovery and is therefore a valuable target for an
intervention. Theory into practice: The UPFRONT intervention is a short cognitive
behavioral therapy intervention for patients that are at-risk of developing
persistent posttraumatic complaints. Patients will undergo five sessions of
cognitive behavioral therapy within 4-10 weeks after trauma. The intervention
aims to enhance patients' feeling of competency of dealing with the consequences
of mild traumatic brain injury by providing psycho-education, identifying and
challenging unrealistic illness perceptions and improving coping style
(decreasing maladaptive coping and enhancing adaptive coping).

Langue : ANGLAIS