Rehabilitation Approaches to the Management of Aggressive Behaviour Disorders after Acquired Brain Injury

2013 ◽  
Vol 14 (1) ◽  
pp. 5-20 ◽  
Author(s):  
Nick Alderman ◽  
Caroline Knight ◽  
Jennifer Brooks
Keyword(s):  
Brain Injury ◽  
Aggressive Behaviour ◽  
Acquired Brain Injury ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Limiting Factor ◽  
Behaviour Disorder ◽  
Behaviour Therapy ◽  
Behavioural Interventions ◽  
Cognitive Behavioural

Symptoms of neurobehavioural disability acquired through brain injury, especially aggression, are associated with severe social handicap. Differences in terminology have resulted in varying estimates, but aggressive behaviour disorder appears to be characteristic of survivors at some point in their recovery journey. This paper provides a brief review regarding the prevalence, development and causes of aggression associated with acquired brain injury (ABI), and what can be done to help manage them. The advantages of using standardised measures conceptualised for ABI in the assessment and formulation of aggressive behaviour disorders are especially highlighted. A range of treatment methods and the evidence base relating to these are described. The contribution of pharmacological therapies, cognitive behavioural therapy and behavioural interventions are explored. It is argued that the strongest evidence base is associated with behaviour therapy, especially when carried out in the context of neurobehavioural rehabilitation, and two case studies are described to illustrate the clinical advantages of interventions derived from operant theory. Comparative lack of ABI experts trained in the management of post-acute behaviour disorders remains a limiting factor.

Cognitive behavioural therapy with older adults: enthusiasm without the evidence?

2009 ◽  
Vol 2 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Philip Wilkinson
Keyword(s):  
Older People ◽  
Methodological Quality ◽  
Evidence Base ◽  
Behavioural Therapy ◽  
Younger Adults ◽  
Behavioural Interventions ◽  
Management Interventions ◽  
Cognitive Behavioural ◽  
Cognitive Behavioural Interventions ◽  
Robust Evidence

AbstractCognitive behavioural interventions specifically for older people have been described and researched for the last 30 years. However, despite a robust evidence base to support the use of CBT in the treatment of mental disorders in younger adults, trials with older people have generally been of poor methodological quality. Therefore, the potential of CBT to improve the outcome of late-life mental illness has not yet been adequately tested and demonstrated. The priorities, if this is to happen, are to develop standardized, reproducible CBT interventions and to evaluate these in large trials alongside medication or as part of case-management interventions.

scholarly journals A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Marthe Ford ◽  
Gert J. Geurtsen ◽  
Erny Groet ◽  
Coen A.M. Van Bennekom ◽  
Eus J.W. Van Someren
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Acquired Brain Injury ◽  
Behavioural Therapy ◽  
Face To Face ◽  
Randomized Controlled ◽  
Cognitive Behavioural ◽  
Insomnia Severity

Abstract Background: Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioural therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioural treatment in this population are scarce, and this applies even more for studies on online cognitive behavioural therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioural therapy for insomnia following acquired brain injury.Methods: A multicenter randomized controlled trial will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioural therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioural therapy sessions given on a weekly basis and personalized feedback after each session, combined with 2 face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 weeks follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation.Discussion: This study will provide insight on the efficacy of online cognitive behavioural therapy for insomnia following stroke and traumatic brain injury.Trial Register: Netherlands Trial Register, NTR7082, 12 March 2018

Cognitive behavioural therapy for aggression among individuals with moderate to severe acquired brain injury: a systematic review and meta-analysis

Brain Injury ◽  
2018 ◽  
Vol 32 (12) ◽  
pp. 1443-1449 ◽  
Author(s):  
Jerome Iruthayarajah ◽  
Fatimah Alibrahim ◽  
Swati Mehta ◽  
Shannon Janzen ◽  
Amanda McIntyre ◽  
...  
Keyword(s):  
Systematic Review ◽  
Brain Injury ◽  
Cognitive Behavioural Therapy ◽  
Meta Analysis ◽  
Acquired Brain Injury ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Severe Acquired Brain Injury

Cognitive Behaviour Therapy for Psychosis: Current Evidence and Future Directions

2008 ◽  
Vol 36 (6) ◽  
pp. 705-712 ◽  
Author(s):  
Craig Steel
Keyword(s):  
Evidence Base ◽  
Behavioural Therapy ◽  
Current Evidence ◽  
Behaviour Therapy ◽  
Theoretical Understanding ◽  
Future Directions ◽  
Cognitive Behavioural ◽  
Cognitive Behaviour ◽  
Current Evidence Base ◽  
Cognitive Behavioural Interventions

AbstractThe past decade has seen considerable growth in the evidence base of cognitive behavioural therapy for psychosis. Consistent reports of moderate effect sizes have led to such interventions being recommended as part of routine clinical practice. Most of this evidence is based on a generic form of CBT for psychosis applied to a heterogeneous group. An increase in the effectiveness of cognitive behavioural interventions may require new protocols. Such therapeutic developments should be based on the theoretical understanding of the psychological processes associated with specific forms of psychotic presentation. The current evidence base of CBT for psychosis is reviewed, and barriers that have held back the development of this research are discussed.

A Randomised Controlled Trial of a Cognitive-Behavioural Therapy Program for Managing Social Anxiety After Acquired Brain Injury

2005 ◽  
Vol 6 (3) ◽  
pp. 169-180 ◽  
Author(s):  
Janet Hodgson ◽  
Skye McDonald ◽  
Robyn Tate ◽  
Paul Gertler
Keyword(s):  
Brain Injury ◽  
Randomised Controlled Trial ◽  
Social Anxiety ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Small Body ◽  
Acquired Brain Injury ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Randomised Controlled

AbstractDespite the prevalence of psychiatric illness in people with acquired brain injury (ABI), there are very few empirically validated studies examining the efficacy of treatments targeting commonly occurring disorders such as depression and anxiety. Using a randomised controlled trial, this study evaluated the efficacy of a cognitive behavioural intervention specifically designed for managing social anxiety following ABI. Twelve brain-injured participants were screened, randomly allocated to either treatment group (TG) or a wait list group (WLG), and proceeded through to the final stages of therapy. The TG received between 9 and 14 hourly, individual sessions of cognitive behavioural therapy. Repeated measures analyses revealed significant improvements in general anxiety, depression and a transient mood measure, tension-anxiety, for the TG when compared to the WLG at posttreatment. These treatment gains were maintained at one-month follow-up. Although in the predicted direction, postintervention improvements in social anxiety and self-esteem for the TG were not significant in comparison with the WLG. This study lends support to the small body of literature highlighting the potential of cognitive behavioural interventions for managing the psychological problems that serve as a barrier to rehabilitation following ABI.

scholarly journals A blended eHealth intervention for insomnia following acquired brain injury study protocol for a randomized controlled trial

2019 ◽  
Author(s):  
Marthe Ford ◽  
Gert J. Geurtsen ◽  
Erny Groet ◽  
Coen A.M. Van Bennekom ◽  
Eus J.W. Van Someren
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Acquired Brain Injury ◽  
Behavioural Therapy ◽  
Face To Face ◽  
Randomized Controlled ◽  
Cognitive Behavioural ◽  
Insomnia Severity

Abstract Background Up to a third of stroke patients and patients with traumatic brain injury suffer from insomnia, including problems to fall asleep or stay asleep at night. Insomnia may exacerbate other brain damage-related problems, for example regarding cognitive functioning and emotional well-being, may lead to poorer quality of life, and may complicate recovery processes. Cognitive behavioural therapy for insomnia, delivered face-to-face or online, is found to be effective in the general population. However, despite the high prevalence and serious consequences of insomnia following acquired brain injury, studies on the efficacy of face-to-face cognitive behavioural treatment in this population are scarce, and this applies even more for studies on online cognitive behavioural therapy. Therefore, this study aims to evaluate the efficacy of a newly developed guided online cognitive behavioural therapy for insomnia following acquired brain injury. Methods A multicenter randomized controlled trial will be conducted, in which 48 patients diagnosed with stroke or traumatic brain injury, and insomnia will be randomly allocated to the online cognitive behavioural therapy for insomnia treatment group or the treatment as usual group. The treatment consists of 6 online cognitive behavioural therapy sessions given on a weekly basis and personalized feedback after each session, combined with face-to-face sessions. Outcomes will be assessed at baseline, immediately after the intervention period and at 6 week follow up. The primary outcome is the insomnia severity assessed with the insomnia severity index. Secondary outcome measures include sleep quality, sleep features derived from the sleep diary, fatigue, anxiety and depression, subjective cognitive functioning and societal participation. Discussion This study will provide insight on the efficacy of online cognitive behavioural therapy for insomnia following stroke and traumatic brain injury. Trial Register Netherlands Trial Register, NTR7082, 12 March 2018

scholarly journals Manualised Cognitive Behaviour Therapy for Anorexia Nervosa: Use of Treatment Modules in the ANTOP Study

2018 ◽  
Vol 7 (11) ◽  
pp. 398 ◽  
Author(s):  
Gaby Resmark ◽  
Brigid Kennedy ◽  
Maria Mayer ◽  
Katrin Giel ◽  
Florian Junne ◽  
...  
Keyword(s):  
Anorexia Nervosa ◽  
Secondary Analysis ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Duration Of Illness ◽  
Cognitive Behavioural ◽  
Outpatient Intervention ◽  
Cognitive Behaviour ◽  
Pros And Cons

Standardised treatment manuals facilitate therapy planning and enhance comparability for research purposes. Within the Anorexia Nervosa Treatment of Out Patients (ANTOP) study, the largest multisite outpatient intervention trial in anorexia nervosa (AN) to date, manualised enhanced cognitive-behavioural therapy (CBT-E) was offered as one treatment modality. The manual consisted of 9 modules, of which Motivation, Nutrition, Formulation and Relapse Prevention were compulsory. Homework worksheets were provided, to ensure the transfer of therapeutic improvements to daily life. This study investigated the use of modules and worksheets in order to explore practice styles of trained therapists in the treatment of AN. This secondary analysis was based on log-sheets (n = 2604) CBT-E therapists completed after each session. Frequencies of modules and worksheets used across all sessions were calculated. Relationships, such as that between use of module and duration of illness, were examined. The most commonly used module was Motivation. In patients with longer illness duration, the module Self Esteem seemed to be particularly important. The worksheet Scales, balancing the pros and cons of AN, was prioritised by therapists. The results underline the importance of motivational work in the treatment of AN, including validating the ambivalence experienced by most AN patients. With increasing duration of illness, resource-oriented elements, such as self esteem stabilisation, should be of focus.

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