This study evaluated the feasibility of
a treatment program utilising Acceptance and
Commitment Therapy (ACT) to address psychological
adjustment to severe traumatic brain
injury (TBI). ACT focuses on persons’ relationship
with internal experiences such as thoughts,
emotions and memories in order for them to live
a life consistent with their values. Treatment
goals include increasing psychological flexibility,
participation in valued life roles and reducing
Method: Two participants (both male, P1 aged 20
years, P2 aged 28 years) with severe TBI and
demonstrating psychological distress, as measured
by the Depression Anxiety and Stress Scale (DASS-
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21), were recruited from the Brain Injury
Rehabilitation Unit, Liverpool Hospital outpatient
service. They jointly engaged in a seven session
treatment program based on ACT principles. Pre
and post-treatment measures of mood, psychological
flexibility and participation were undertaken in
addition to sessional measures. Statistical analysis
involved calculating reliable change for single case
Results: Both participants demonstrated improvements
in their psychological flexibility with P1’s
change being significant (P1 RCI¼1.98, P2
RCI¼1.38). They both demonstrated significant
decreases in their level of psychological distress (P1
DASS-stress RCI¼ -.2.54, P2 DASS-anxiety RCI¼
-5.11). P2 also reported an increase of 6.9 points on
participation, approaching the criterion for significant
reliable change (a change of 8 points).
Moreover, both participants achieved goals set in
accordance with their values.
Conclusions: ACT shows initial promise as a
suitable therapy to improve psychological flexibility,
increase participation and reduce psychological
distress among people with severe TBI.
Further research needs to assess the program in
a controlled trial with a larger sample.