A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma)

Abstract

A single-case experimental evaluation of a new group-based intervention to enhance adjustment to life with acquired brain injury: VaLiANT (valued living after neurological trauma)', Neuropsychological Rehabilitation.

Does Integrating Cognitive and Psychological Interventions Enhance Wellbeing After Acquired Brain Injury? Study Protocol for a Phase II Randomized Controlled Trial of the VaLiANT (Valued Living After Neurological Trauma) Group Program

“…While a number of complex interventions have integrated cognitive rehabilitation and psychological therapy with subsequent positive long-term effects, these interventions are lengthy and require high treatment dosage which limits their implementation into routine practice. The proposed RCT aims to build on our Phase I findings ( 55 ) by evaluating the efficacy, feasibility, and acceptability of the 8-week VaLiANT group program against a treatment-as-usual waitlist control.…”

“…Group delivery was chosen due to a number of factors: 1) the cost-effectiveness compared to individual treatment, 2) the additional benefit of group discussion and the sharing of ideas for particular topics e.g., strategies to manage particular difficulties following ABI, and 3) to address social isolation and provide access to other individuals with shared experience. A number of small revisions were made to the manual and treatment delivery following completion of the Phase I study ( 55 ): 1) additional scaffolding was added in Session 2 to assist participants with linking their values to behavior, 2) a mindfulness exercise was included in every session (previously was in most but not all sessions), and 3) email reminders for the homework activities were sent to participants at the end of each calendar week. The treatment manual and resources will be published following completion of the trial.…”

“…The Warwick-Edinburgh Mental Wellbeing Scale (WEMWBS) was selected as the primary outcome measure as it captures the broader adjustment and quality of life outcomes that VaLiANT targets, and the majority of participants displayed reliable and clinically significant improvements on the measure during the Phase I evaluation of VaLiANT ( 55 ). The WEMWBS is a 14-item questionnaire that measures the frequency of positive mental health and wellbeing over the previous 2 weeks ( 64 ).…”

“…Feasibility of the trial design will be assessed against the following criteria: 1) recruitment of the minimum number of participants required to run quarterly groups throughout 1 the study period (minimum of 3 participants per group); 2) acceptable participant drop-out rates in intervention and control conditions (<20%); 3) adequate outcome assessment completion rates (≥80%); and 4) successful blinding of outcome assessors (≥90%). Consistent with the Phase I study (55), feasibility of the intervention will be assessed against: 1) group attendance rates (≥80% overall participant attendance); 2) and homework completion rates (≥50% completion rate for participants in attendance for each session). Acceptability of the intervention is measured by asking participants to rate their level of confidence in recommending the VaLiANT program to a friend who experiences similar problems (1 = "Not at all confident, " 9 = "Very confident").…”

“…Valued Living After Neurological Trauma (VaLiANT) is a new 8-week group intervention that aims to enhance adjustment to life with ABI by combining cognitive rehabilitation and psychological therapy using ACT principles. A Phase I study has been completed using a single case experimental design repeated across eight participants ( 55 ). This study demonstrated reliable improvements to a broad range of outcomes for the majority of participants, including overall wellbeing, anxiety symptoms, and subjective cognitive complaints.…”