Behavioural activation therapy to improve participation in adults with depression following brain injury: A single-case experimental design study

ABSTRACT

Following brain injury, the risk of depression increases. There are few studies of non-pharmacological interventions for this problem. Behavioural Activation (BA) could help because it has been demonstrated to be as effective as cognitive-behaviour therapy but is less cognitively demanding and more suitable for people with brain impairment. The current study evaluated BA using a multiple-baseline design across behaviours with replication. Three male participants with clinically significant depressive symptoms (two with traumatic brain injury aged 26 and 46, one who experienced strokes in infancy, aged 26) engaged in a 10-14-week trial of BA focusing on three activity domains: physical, social and functional activities. Participants completed an online form three times a day which recorded activity participation and responses to a single-item mood scale. There was little evidence in support of BA for increasing participation. There was also a lack of change in average mood, but some positive effects were found on measures of depression symptoms and quality of life in these participants. Various factors affected participation which might have been mitigated by extended treatment contact, greater use of prompts or electronic aids or the addition of other therapy modes.

KEYWORDS:

• Acquired brain injury
• Behavioural activation
• Major depressive disorder
• Single-item mood scale
• Single case experimental design

Acknowledgements

We thank Dr Amanda Lane-Brown for undertaking the secondary ratings of outcome data and treatment adherence, and Dr Michael Perdices for advice in planning data analyses and assisting with interpretation of data.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The authors acknowledge the provision of a grant from the Moving Ahead Centre for Research Excellence, which funded the rating of outcome data and treatment adherence.