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Overall Distress* Depression* Anxiety* Stress
Pre-intervention Post-intervention
50
40
30
20
10
0
CBT
17
EFT
5
ACT
4
Note. * p < .05
A Virtual Group Therapy Paradigm
for Individuals with
Acquired Brain Injuries
Sanya Sagar, M.A., & Emilie Sheppard, Ph.D.
Introduction
Acquired brain injuries (ABI; brain injuries caused by trauma, infection, disease, anoxia,
strokes, tumours, and surgeries) are widely prevalent and result in profound
consequences, including clinically significant symptoms of depression and anxiety.
Cognitive behavioural therapy (CBT) is an empirically validated treatment for
depression and anxiety in medical populations, delivered individually and in group
format. The COVID-19 pandemic brought the pre-existing need for improved access to
psychological care to the forefront. However, little research has been conducted on
group CBT delivered virtually.
Objective
To develop and
evaluate a
virtual CBT group
for individuals with
ABI during the
COVID-19
pandemic
Relevant Literature
Aboulafia-Brakha et al. (2013). Feasibility
and initial efficacy of a cognitive-behavioural
group programme for managing anger and
aggressiveness after traumatic brain injury.
Neuropsychological Rehabilitation.
https://doi.org/10.1080/09602011.2012.7474
43
Nguyen et al. (2017). Cognitive Behavior
Therapy to Treat Sleep Disturbance and
Fatigue Following Traumatic Brain Injury: A
Pilot Randomized Controlled Trial. Archives
of Physical Medicine and Rehabilitation.
https://doi.org/10.1016/j.apmr.2017.02.031
Methodology
Adults with mild-to-severe ABI
were offered participation in a
new, 12-week, virtual group CBT
program. The program was
developed using materials from a
previous in-person CBT group,
adapted for virtual therapy with
individuals with ABI. Due to the
needs of the group and the
experience of the facilitators,
interventions from acceptance and
commitment therapy (ACT) and
emotion-focused therapy (EFT)
were integrated into the
treatment.
Results
Overall distress scores reduced from pre- to post-
intervention (large effect size)
Participants showed significant reductions in
depression and anxiety symptoms from pre- to
post-intervention (large effect size)
Level of stress did not change over time
Implications and Future Directions
Group CBT delivered virtually is no less effective than
group CBT provided in-person, while contributing to
the promotion of equity in accessing healthcare
Exploratory results suggest that other treatment
modalities (e.g., ACT, EFT) may be useful for
individuals with ABI; this is an important avenue for
future research
Healthcare practitioners are encouraged to consider
offering virtual psychotherapy and group therapy in
order to increase the equitable distribution of their
services
Scores
Time
Figure 1. Number of interventions per primary modality
Figure 2. Symptom scores pre- and post-intervention
Pre- and post-intervention symptoms collected using the
Depression Anxiety Stress Scale (DASS) from a final sample of
eight adults (ages 31 to 57) were analyzed using repeated
measures analysis of variance (ANOVA).
Methodology