The use of Motivational Interviewing and cognitive behavioural therapy to treat anxiety and/or depression following traumatic brain injury

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Individuals with traumatic brain injury (TBI) are prone to experiencing psychological distress, especially anxiety and depression. Cognitive-behavioural therapy (CBT) is a promising treatment for anxiety disorders in people with TBI of the mild-moderate spectrum. However, the effectiveness of CBT to treat anxiety disorders in those with moderate-severe TBI is still not well-understood, and this subgroup tends to have longer-lasting cognitive problems such as poor memory and problem solving. Furthermore, there has been very limited research investigating ways of enhancing treatment response in those with moderate-severe TBI. This presents significant challenges to treatment providers, as effective management of anxiety disorders inevitably involves a person to confront some entrenched patterns of fears and worries. The proposed study aims to examine the efficacy of an evidence-based CBT programme as a treatment of anxiety disorders for individuals with moderate-severe TBI. The study will also examine the effects of a brief preparatory intervention on treatment engagement and response rate. In addition, factors which influence participants’ treatment response and experience with therapy will be explored. A number of questionnaires, designed to measure levels of anxiety, psychosocial and community reintegration, self-awareness, and beliefs about one’s ability to control anxiety will be given to participants. Participant’s level of cognitive functioning will also be assessed in order to examine the impact of cognitive problems on their potential to benefit from CBT. The project is designed such that a control component is embedded in the form of treatment-as-usual wait list protocols. This enables all participants to have access to the intervention while also ensuring high quality empirical evidence. Effective interventions are urgently required in order to prevent prolonged psychological distress and to improve the quality of life for individuals who have had sustained TBI. This project is expected to contribute to our understanding of ways of assisting individuals to manage anxiety, hence improving their psychosocial functioning.

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