The value of normalization: Group therapy for individuals with brain injury

Mensenkampff, Barbara von; Ward, Marcia M.; Grace, Kelly; Cadogan, Sam; Fawsit, Feargus; Lowe, Niamh

doi:10.3109/02699052.2015.1042407

Cited by 13 publications

(7 citation statements)

References 30 publications

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“…Studies examining this construct have noted that when individuals do not understand their experiences (e.g., frequency of cognitive difficulties during menopause, normal age-related changes), they tend to believe their symptoms are unique and that they are less capable or competent than peers which can understandably translate into increased worry ( 92 ). Group interventions facilitate a normalisation process wherein individuals learn that others share their experiences and challenges, and improve adjustment difficulties ( 93 ). Indeed, qualitative information provided by study participants at the post-group assessment indicated a reduction in concerns about dementia following group completion for some, suggesting that their cognitive symptoms were normalised and contextualised.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study

Ballantyne¹,

King²,

Green³

2021

Front. Glob. Womens Health

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Background: Menopause is associated with physical and emotional symptoms, and subjective cognitive concerns that are generally not borne out on objective cognitive measures. This discrepancy suggests that a psychological rather than biological mechanism likely mediates the cognitive concerns of women in menopause. The current study assessed the feasibility and effectiveness of a cognitive remediation intervention with the goal of reducing subjective perceptions of cognitive difficulty during the menopause.Methods: Twenty-seven menopausal women (M age = 53.74, SD = 4.14) completed a 5-week group-based intervention (with a post-group booster) consisting of 2-h weekly sessions. Participants completed pre- and post-intervention measures capturing subjective cognitive ability, mood, anxiety, stress, personality, and objective cognitive tests. The primary variable of interest was self-reported cognitive confidence measured by the Memory and Cognitive Confidence Scale (MACCS).Results: All but one MACCS subscale significantly decreased over the course of treatment (with lower scores associated with higher confidence) and effect sizes ranged from small to large (d = −0.39 to −0.91) with gains maintained at 1-month follow-up. Interestingly, no change in objective cognitive test performance was observed, indicating increases in subjective cognitive confidence in the absence of objective cognitive improvement. There was no change in mood, anxiety, or stress scores. Two-level HLM analyses revealed that those with higher baseline neuroticism, as measured by the NEO Personality Inventory, had smaller decreases in post-group MACCS High Standards subscale relative to those with lower baseline neuroticism (p = 0.027, d = −0.45). Those with higher baseline depression scores on the Depression Anxiety Stress Scale (DASS-21) had a smaller decrease in post-intervention MACCS Total Score relative to those with lower depression ratings.Conclusion: To our knowledge, this is the first feasibility study of its kind targeting perceptions of cognitive impairment during menopause. Although generally well-tolerated, recruitment and scheduling difficulties were flagged as challenges to engagement while a small sample size and lack of control group limit conclusions about efficacy. Providing current results could be replicated with enhanced methods, these results provide support that cognitive remediation is a feasible and credible treatment, and may improve quality of life for women in menopause.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03311880.

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Section: Discussionmentioning

confidence: 99%

Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study

Ballantyne¹,

King²,

Green³

2021

Front. Glob. Womens Health

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“…The requirement for therapeutic assistance for both the processing of loss and mourning for pre‐injury self, and in the construction of a new sense of self is evidenced. Previous studies outline that emotional adjustment is the foundation of rehabilitation (von Mensenkampff et al, 2015). This study adds to literature by highlighting that psychotherapy may also be a necessary process in addressing loneliness and social re‐integration for some individuals living with brain injury.…”

Section: Discussionmentioning

confidence: 99%

‘Lonely in my head’: The experiences of loneliness in individuals with brain injury

Lowe

Crawley

Wilson

et al. 2020

British J Health Psychol

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Primary objective. This paper reports on the personal experiences of loneliness for individuals living with brain injury.Research design. This is a qualitative research design, employing semi-structured interviews and subsequent contextualist thematic analysis.Methods and procedures. Eleven clients (two female and nine male, aged between 27 and 63 years) with brain injury participated in semi-structured interviews. Thematic analysis was employed in the interpretation of the data.Main outcomes and results. The interview data and subsequent analysis depicted three overarching themes in a healing process -'Internal Loneliness', 'Healing the Cracks', and 'Visible with Cracks'. Participants described five factors which contribute to their feeling of loneliness: trauma, social isolation, concealment, rejection of part of self, and invisibility of their disability. The participants' accounts also detailed the necessity of a therapeutic intervention and relationship to deal with and address some of these issues.Conclusions. This study highlights that processing the trauma, developing dialectical thinking, self-compassion, and a degree of self-acceptance assist in the movement of participants towards allowing themselves to be 'Visible with Cracks'. This allowance of self to be fully seen appears to serve an important function for reconnection with self and others. These results may help to inform brain injury rehabilitative care, through developing their understanding of the internal loneliness factors that may be influencing an individual's social isolation or social withdrawal. Statement of contributionWhat is already known on this subject?Individuals with brain injury continue to report significant problems developing social contacts and maintaining significant relationships years post-injury. Social needs often outweigh the physical and cognitive needs in ranking of importance by both individuals with brain injury themselves and their families.

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“…Social isolation and adjustment are significant issues following TBI [3,38,40,41], and the finding that groups contribute to the development of relationships outside of the group provides support for the use of groups even in the early stages of inpatient rehabilitation.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Groups are commonly used in health care [1]. The value of opportunities for peer support and learning, and adjustment following injury or illness are consistently identified in the rehabilitation literature [2][3][4]. Rehabilitation groups can be used for education, to practice skills and strategies, to maximize therapy intensity, and to provide opportunities for peer support [1,2].…”

Section: Introductionmentioning

confidence: 99%

Patient perceptions of participation in group-based rehabilitation in an inpatient brain injury rehabilitation setting

Patterson

Fleming

Doig

2019

Patient Education and Counseling

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The value of normalization: Group therapy for individuals with brain injury

Abstract: Findings are encouraging and help to validate the effectiveness of group therapy as an intervention tool.

Cited by 13 publications

References 30 publications

Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study

Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study

‘Lonely in my head’: The experiences of loneliness in individuals with brain injury

Patient perceptions of participation in group-based rehabilitation in an inpatient brain injury rehabilitation setting

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