Feasibility and initial efficacy of project‐based treatment for people with ABI

Abstract

Background Communication impairments are common and pervasive for people a long time following acquired brain injury (ABI). These impairments have a significant impact on a person's quality of life (QOL) post‐injury. Project‐based treatment is a treatment approach that could have an impact on communication skills and QOL for people with ABI a long‐term post‐injury. This treatment is embedded in a context of meaningful activities chosen by people with ABI, whereby, as a group, they work collaboratively to achieve a tangible end product. Aims To evaluate the feasibility and initial efficacy of project‐based treatment on improving the communication skills and QOL for people with ABI. Methods & Procedures An exploratory controlled trial with alternate allocation of groups, and follow‐up at 6–8 weeks, was completed. Twenty‐one people with chronic ABI were recruited in groups of two to three from community settings, allocated to either a TREATMENT (n = 11) or WAITLIST group (n = 10). Participants attended a 20‐h group‐based treatment over 6 weeks where they worked towards achieving a project that helped others. To determine feasibility, four criteria were used: demand, implementation, practicality and acceptability. A range of communication and QOL outcomes was used to determine a fifth feasibility criterion, initial efficacy. Some of these criteria were additionally used to evaluate the feasibility of the outcomes. Outcomes & Results All participants received the treatment as allocated with high attendance and no dropouts. The treatment was feasible to deliver as intended and was highly acceptable to participants. Medium and large effect sizes were found from pre‐ to post‐treatment, and from pre‐treatment to follow‐up for measures of conversation, perceived communicative ability and QOL. Conclusions & Implications Project‐based treatment is feasible with indications of initial efficacy for both communication skills and QOL. The treatment provides a promising new approach for improving communication skills and QOL in people with chronic acquired brain injuries in the community setting.

Goal Attainment in an Individually Tailored and Home-Based Intervention in the Chronic Phase after Traumatic Brain Injury

“…Recently, Trevena-Peters, McKay [55] published results from a randomized controlled trial (RCT) supporting the effectiveness of an intervention to improve activities of daily living during post-traumatic amnesia, providing detailed results from GAS. A feasibility study of a project-based intervention for acquired brain injuries also detailed goal attainment results [56]. However, the studies neither provided information on the attainability of goals in distinct domains, nor did they investigate predictors of goal attainment.…”

Reporting on novel complex intervention development for adults with social communication impairments after acquired brain injury

“…Two of these -a tangible project output and group-based intervention - suggests that group context is crucial [61,62,63] and the pursuit of goals is integral to success [61]. Helpfully, the positive feasibility results from our main study [27] confirm these essential elements can be implemented. Participants could identify and complete projects during the intervention period, participants attended the groups and reported positive experiences of working with others, participants achieved communication goals, strategies for addressing impairments in cognition and awareness were implemented (e.g.…”

“…Fidelity materials could also be developed and tested on three treatment groups as part of a broader feasibility trial [27].…”

“…Our intervention has been tested in a study, comparing the group-based intervention to usual care using a waitlist-controlled design in 21 adults with ABI, where participants engaged in small groups of 2-3 participants [27]. Findings indicate the intervention was feasible and led to some positive changes in communication skills and QOL.…”

Setting and achieving individualized social communication goals for people with acquired brain injury (ABI) within a group treatment

“…This paper reports on the use of GAS to set goals, which was incorporated into a controlled group treatment trial for people with ABI (Behn et al . ). The first hypothesis was that individualized social communication goals could be set and measured using GAS within a broader, group‐based treatment.…”