2020
DOI: 10.1017/s1355617719000791
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Predictors of Anxiety and Depression Symptom Improvement in CBT Adapted for Traumatic Brain Injury: Pre/Post-Injury and Therapy Process Factors

Abstract: Objectives:The current study examined the association of demographic/preinjury, injury-related, and cognitive behavior therapy (CBT) process variables, with anxiety and depression symptom change in traumatic brain injury (TBI)-adapted CBT (CBT-ABI).Methods:The audio recordings of 177 CBT-ABI sessions representing 31 therapist–client dyads were assessed from the independent observer perspective on measures of working alliance, homework engagement, and therapist competency in using homework.Results:Linear regres… Show more

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Cited by 16 publications
(20 citation statements)
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“…Examples include dysfunctional thought records, pros and cons, behavioral experiments, and breaking tasks down. A higher degree of homework adherence has been significantly associated with reductions in symptoms across a range of clinical populations (e.g., Aguilera et al 2018;Arendt et al 2016;Callan et al 2019;Zelencich et al 2020) and the adherenceoutcome relationship has been a robust finding within metaanalytic reviews (Kazantzis et al 2016). However, simple correlational analyses may underestimate the magnitude of homework effects in CBT.…”
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confidence: 99%
“…Examples include dysfunctional thought records, pros and cons, behavioral experiments, and breaking tasks down. A higher degree of homework adherence has been significantly associated with reductions in symptoms across a range of clinical populations (e.g., Aguilera et al 2018;Arendt et al 2016;Callan et al 2019;Zelencich et al 2020) and the adherenceoutcome relationship has been a robust finding within metaanalytic reviews (Kazantzis et al 2016). However, simple correlational analyses may underestimate the magnitude of homework effects in CBT.…”
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confidence: 99%
“…The effect of age may be mitigated when evaluated continuously, as in this study, or when assessing PSQI scores along a continuum over time. Our study combined stroke and TBI participants, and as TBI is commonly associated with a younger age group, its significance may have been weakened, possibly explaining differential findings to Zelencich et al,16 who focused only on TBI. Ponsford et al17 evaluated age at injury, whereas we examined age at entry to treatment.…”
Section: Discussionmentioning
confidence: 89%
“…Better cognitive functioning, particularly memory 15,19 and executive functioning, 16 has been linked to better CBT outcomes, but not general intelligence. 16,19 Therapy process variables including higher levels of client homework engagement and higher therapist competence in reviewing homework are also associated with greater improvements after CBT for individuals with ABI. 16 In addition to patient characteristics, the mode of treatment delivery is important to consider when examining outcomes after CBT.…”
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confidence: 99%
“…There was detailed planning and problem-solving around homework tasks and an emphasis on homework review each week. This was important given the impact that executive impairments and memory difficulties can have on homework engagement for individuals with ABI and ultimately an individual’s capacity to benefit from CBT [ 26 ]. Conversely, the HE control condition provided a predetermined set of information and generalised strategies, and did not include the creation or setting of homework tasks.…”
Section: Methodsmentioning
confidence: 99%