Could neurosurgical patients benefit from psychotherapy? A few words on the use of cognitive-behavioural therapy in brain injured patients

Abstract

Numerous studies have shown the effectiveness of cognitive-behavioural therapy in the treatment of various mental disorders. The present study reviews the available literature on the use and effectiveness of this therapy, both its classic form and more recent approaches (the so called “third wave”), among patients with brain injuries and those treated with surgical methods. We present a number of studies describing the use of cognitive-behavioural therapy in the treatment of patients with craniocerebral injuries, brain tumours, intracranial bleeding and vascular malformations. The obtained results are promising for the treatment of depression and anxiety disorders, post-traumatic stress disorder as well as sleep disorders, impulsivity and aggressive behaviour. The findings suggest that cognitive-behavioural therapy techniques may be effective in both these groups of patients and their families or caregivers. Currently, due to the small number of randomised controlled trials, high heterogeneity of study groups and a variety of research protocols, these findings do not allow for drawing final conclusions and proposing recommendations. Nevertheless, they demonstrate that the strategy offers promise when treating patients with brain damage. It is suggested that psychotherapy should be initiated after the end of the acute phase of the disease as it requires a certain level of self-awareness and an ability to test hypotheses, so it may be inadequate for patients with profound cognitive impairment. It requires the cooperation of a multidisciplinary team: doctors, physiotherapist, neuropsychologist and psychotherapist who, in addition to therapeutic skills, should have knowledge of the brain–behaviour relationship.