Individualized goal attainment scaling during a trial of positive behaviour support in adults with acquired brain injury

ABSTRACT

Background: Challenging behaviours after acquired brain injury (ABI) cause distress and reduce community participation. Evidence-based and effective interventions are needed. Positive Behaviour Support (PBS) interventions, such as PBS + PLUS, are person-driven and context-sensitive approaches which aim to improve quality of life and enhance behavioural self-regulation. This study aimed to expand the empirical outcomes of a recent waitlist-controlled trial of PBS + PLUS by examining individualized goal attainment. Method: Participants were 44 adults with severe ABI sustained on average nine years previously (Range = 0.6–26) from the combined trial cohort who completed the intervention. Using Goal Attainment Scaling, trial therapists developed and reviewed goals collaboratively with the person with ABI and their natural supports. Results: The 182 goals in the sample focussed on psychological wellbeing, interpersonal relationships, routines and self-care. By the end of 12-month intervention, 84.6% of goals were achieved and 53.3% exceeded their expected outcome. Conclusions: These findings indicate high levels of personally meaningful outcomes in a broad range of life-domains can be obtained for participants with severe ABI using PBS + PLUS. Whilst these results should be considered in combination with the findings of the waitlist-controlled trial, they contribute to the growing literature regarding benefits of PBS in enhancing quality of life post-ABI.

Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12616001704482.

KEYWORDS:

• Acquired brain injury
• Challenging behaviour
• Positive behaviour support
• Intervention
• Goal attainment

Acknowledgements

The authors would like to acknowledge and gratefully thank the generosity, time and effort of the participants and their support networks; therapists (Dr Kate Gould, Dr Belinda Renison, Dr Kim Trezise, Dr Diane Parcell, Nadine Holgate, Cathy Bucolo, Sally Peterson, and Dr Clare Kempnich); independent rater Dr Toni Withiel; Dr Marina Downing for feedback on an earlier draft; and research staff at the Monash-Epworth Rehabilitation Research Centre.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by funding from the Transport Accident Commission through the Institute for Safety Compensation and Recovery Research [Grant Number 135].