Acceptance and commitment therapy for individuals with depressive and anxiety symptoms following acquired brain injury: A non-concurrent multiple baseline design across four cases

Neuropsychol Rehabil. 2023 Jul;33(6):1018-1048. doi: 10.1080/09602011.2022.2053169. Epub 2022 Mar 25.

Abstract

Patients with acquired brain injury (ABI) often experience symptoms of anxiety and depression. Until now, evidence-based treatment is scarce. This study aimed to investigate the effectiveness of Acceptance and Commitment Therapy (ACT) for patients with ABI. To evaluate the effect of ACT for people with ABI, a non-concurrent multiple baseline design across four cases was used. Participants were randomly assigned to a baseline period, followed by treatment and then follow-up phases. Anxiety and depressive symptoms were repeatedly measured. During six measurement moments over a year, participants filled in questionnaires measuring anxiety, depression, stress, participation, quality of life, and ACT-related processes. Randomization tests and NAP scores were used to calculate the level of change across phases. Clinically significant change was defined with the Reliable Change Index. Three out of four participants showed medium to large decreases in anxiety and depressive symptoms (NAP = 0.85 till 0.99). Furthermore, participants showed improvements regarding stress, cognitive fusion, and quality of life. There were no improvements regarding psychological flexibility, value-driven behaviour, or social participation. This study shows that ACT is possibly an effective treatment option for people experiencing ABI-related anxiety and depression symptoms. Replication with single case or large scale group studies is needed to confirm these findings.

Keywords: Acceptance and commitment therapy; Acquired brain injury; Anxiety and depressive symptoms; Single-case experimental design.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acceptance and Commitment Therapy*
  • Anxiety / etiology
  • Anxiety / therapy
  • Anxiety Disorders
  • Brain Injuries*
  • Depression / diagnosis
  • Depression / etiology
  • Depression / therapy
  • Humans
  • Quality of Life

Grants and funding

This work was supported by ZonMW under Grant (project number 636310003). The funder had no role in the study design, data collection, data analysis, data interpretation, or writing of the manuscript.