Behavioral couples therapy for brain injury: single case methodology with bi-phasic design

ABSTRACT

Objectives

To explore the outcomes of Behavioral Couples Therapy (BCT) for couples with brain injury.

Background

Brain injury can result in communication, emotional and behavioral disturbances, leading to higher levels of depression, anxiety and relationship distress. Currently, no study has explored the outcomes of BCT in couples impacted by brain injury.

Method

Four heterosexual couples living with brain injury were seen at a specialist outpatient service, and attended an average of 13 (range 8–25) BCT sessions. Participants with brain injury and their partners completed weekly measures of depression, anxiety, and couple satisfaction throughout baseline, assessment, intervention, and follow-up phases. Data were visually analyzed, and effects examined using reliable change analysis, and between-phase comparison conducted using Tau-U.

Results

Tau-U analysis demonstrated that both the patient and partner groups experienced significant overall improvement in relationship satisfaction and anxiety. Partners also reported significant reduction in depression scores overall. Reliable change analysis indicated improvement for some individual patients and partners, with effects maintained at follow-up in some cases.

Conclusions

The results offer promising results regarding the use of BCT for brain injury in increasing relationship satisfaction and reducing psychological distress. Further investigation is warranted.

KEYWORDS:

• Behavioral couples therapy
• depression
• anxiety
• brain injury
• Couple work

Acknowledgments

The authors would like to acknowledge the contribution of Donald H. Baucom, Melanie S. Fischer, Michael Worrell and Sarah Corrie who were the originators of BCT training in the UK and whose training provided the foundations for the innovations in BCT reported here.

Huge thanks to all the patients and their spouse who took part in the project, a special thanks goes to St George’s University Hospital NHS Foundation Trust, and Shai Betteridge for her support and encouragement of the service development.

Disclosure statement

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

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/02699052.2022.2145367

Notes

1. “Behavioral Couples Therapy (BCT), termed Cognitive Behavioral Couple Therapy in the USA”

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.