An acceptance and commitment therapy-based intervention for PTSD following traumatic brain injury: a case study

ABSTRACT

Introduction: A case study is presented to illustrate the management of Post-Traumatic Stress Disorder (PTSD) in the context of Traumatic Brain Injury (TBI), using an Acceptance and Commitment Therapy (ACT) based approach. A 48-year-old female presented to Neuropsychology with cognitive difficulties, significant distress and trauma symptoms following a car accident. ACT is a third wave cognitive-behavioral approach aimed at increasing psychological flexibility as a means of reducing distress: it is a trans-diagnostic model that may be suited to the complex and multi-factorial difficulties experienced by this client group.

Methods: A guided self-help approach based on ACT was implemented by the client working with a Clinical Psychologist within a Community Neuropsychology service, over 12 appointments.

Results: Outcome measures were administered pre and post-intervention as well as at three and then 12-month follow-ups. Improvements were seen across ACT outcome measures, psychological measures and quality of life ratings and were consistent with subjective reporting.

Discussion: Outcomes were positive in all domains post-intervention and at follow-up, indicating that this may be a feasible intervention for PTSD following TBI.

KEYWORDS:

• Acceptance and commitment therapy (ACT)
• post traumatic stress disorder (PTSD)
• traumatic brain injury (TBI)
• psychological flexibility
• neuropsychological rehabilitation

Acknowledgments

Thanks to my wonderful team, headed up by Dr Gemma Elliott, for both professional and personal support that goes above and beyond the call of duty.

Declaration of Interest

This work was completed as part of routine clinical practice within the author’s role as a Clinical Psychologist in a Community Neuropsychology team. This case study was also submitted as part of the author’s practice portfolio for the Qualification in Clinical Neuropsychology.

Notes

1. Hereafter this pseudonym will be used to protect the client’s confidentiality. All other names or references to places that may breach confidentiality have also been changed. Informed consent obtained from client.