Is telephone delivery of the Strength 2 Strength (S2S) group program a feasible way to build resilience among family members supporting relatives with Acquired Brain Injury (ABI)?

Brief Name: S2S Phone-Based Feasibility and Pilot Study The S2S program was created as a ten hour group-based psycho-educational program to build resilience among family members supporting relatives with TBI. An abbreviated five hour version was developed to make it more accessible (less time demand and ease of forming a group) as a single workshop or a 5 session telehealth intervention but the telehealth abbreviated program has rarely been used. Both the full and abbreviated S2S programs use a manual with structured content and format for each of the 5 sessions that comprise the program. There are standard information handouts and worksheets for use in each session and these are provided to the group participants before the commencement of the program. Group facilitators are trained to understand the premise of the program and its delivery using the manual. The manual's title is: Strength2Strength. Building Family Resilience after Traumatic Injury. A Psycho-educational Program. The psycho-educational program aims to build resilience through providing information, emotional support and skills acquisition. The five sessions within the group program are entitled: 1. Telling Your Story – sharing your experience to date; 2. Active Participation – learning strategies to feel less overwhelmed and manage life; 3. Staying on Top – identifying strengths used to adapt to life challenges; 4. Regaining some Balance – exploring strategies to look after yourself; 5. Staying Connected – with family, friends and community supports. The intervention study aimed to test the (i) feasibility, (ii) outcomes, and (iii) acceptability of a phone-based delivery of the abbreviated five-hour version of the S2S group program among family members of individuals with ABI living in rural New South Wales (NSW). A quasi-experimental single group design was employed. Three separate telephone groups were conducted between 2016 and 2018 and were delivered to family members of adult clients of the Mid-Western Brain Injury Rehabilitation Program (MWBIRP). This service operates from Bathurst Health Service and provides a multidisciplinary outreach community rehabilitation program to adults of working age living within a defined geographic area. It takes three hours to drive to the furthest town serviced from Bathurst. The MWBIRP is one service within the NSW Brain Injury Rehabilitation Program – a service network covering the majority of NSW. The S2S Phone intervention was delivered by a senior social worker and clinical psychologist with high level group facilitation skills and with experience in brain injury rehabilitation and working with families. The two facilitators delivered the program in the following way: a) all course resource material was sent to participants (either email or regular mail) before the commencement of the program. This material included content handouts and exercise tools, worksheets for specific session content, a dvd showing guest speaker in session 2, b) the 2 facilitators met with all group participants using NSW Health group teleconferencing facilities accessible at no cost to the participants and available through landlines and mobile telephones. This created a group setting. The group met at a planned time once a week for 1.25 hours for 5 weeks. Monitoring of adherence to the intervention occurred by: a) facilitators keeping an attendance list for each session; b) if any participant missed a session, then before the next week's session one of the facilitators spoke with the participant about the material covered during the missed session, the contributions made by other participants during the session and explored the participant's views about the discussion topic; c) data was collected from each participant concerning the process and content of each session. This was done by means of a Session Satisfaction Sheet which participants were asked to complete at the end of each weekly session. This sought ratings about relevance of the content, clarity of the material, whether content covered the aims and objectives, whether they liked the mix of activities and discussion, whether the session timing was suitable, which activity they found useful, what they enjoyed the most in the session. c) at the beginning of each session facilitators summarised the previous week's group experience and confirmed whether participants had prepared for the session and whether they had practised any particular skill previously introduced.