Faulkner Josh W, Chua Jason, Voice-Powell Amabelle, Snell Deborah L, Roche Maree, Moffat John, Barker-Collo Suzanne, Theadom Alice
Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand.
TBI Network, Auckland University of Technology, Northcote, Auckland, New Zealand.
PLoS One. 2025 Jan 30;20(1):e0312940. doi: 10.1371/journal.pone.0312940. eCollection 2025.
Psychological interventions may make a valuable contribution to recovery following a mild traumatic brain injury (mTBI) and have been advocated for in treatment consensus guidelines. Acceptance and Commitment Therapy (ACT) is a more recently developed therapeutic option that may offer an effective approach. Consequently, we developed ACTion mTBI, a 5-session ACT-informed intervention protocol. To establish the feasibility of this intervention, we wanted to understand participants' experiences of ACTion mTBI, determine acceptability and identify any refinements needed to inform a full-scale effectiveness trial. We recruited adults (≥16 years of age) diagnosed with mTBI who were engaged in community-based multidisciplinary rehabilitation. After completing the ACTion mTBI sessions, 23/27 (85.2%) participants (mean time post-injury: 28.0 weeks) completed a semi-structured interview about their experience of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a qualitative description approach. There were two overarching themes 1) attacking the concussion from a different direction and 2) positive impact on recovery which depicted participants' overall experiences of the intervention. Within these overarching themes, our analysis also identified two subthemes: 1) helpful aspects of the intervention which included education and ACT processes (i.e., being present and being able to step back) and 2) "contextual factors that enabled intervention effectiveness" which included being equipped with tools, cultural and spiritual responsiveness, the therapeutic connection, and the intervention having a structured yet flexible approach to order of delivery to meet individual needs. Participants' experiences support acceptability, cultural and spiritual responsibility of ACTion mTBI. Suggested refinements included enabling access to intervention over time, not just at one point during recovery and the addition of a brief check-in follow-up.
心理干预可能对轻度创伤性脑损伤（mTBI）后的康复做出重要贡献，并且在治疗共识指南中也得到了提倡。接纳与承诺疗法（ACT）是一种较新开发的治疗选择，可能提供一种有效的方法。因此，我们开发了ACTion mTBI，这是一个为期5节的基于ACT的干预方案。为了确定这种干预的可行性，我们想了解参与者对ACTion mTBI的体验，确定其可接受性，并确定全面有效性试验所需的任何改进。我们招募了被诊断为mTBI且正在接受社区多学科康复治疗的成年人（≥16岁）。在完成ACTion mTBI课程后，23/27（85.2%）的参与者（受伤后平均时间：28.0周）完成了关于他们干预体验的半结构化访谈。访谈进行了录音，逐字转录，并采用定性描述方法进行分析。有两个总体主题：1）从不同方向应对脑震荡和2）对康复的积极影响，描述了参与者对干预的总体体验。在这些总体主题中，我们的分析还确定了两个子主题：1）干预的有益方面，包括教育和ACT过程（即活在当下和能够退后一步），以及2）“使干预有效成为可能的背景因素”，包括配备工具、文化和精神响应能力、治疗联系，以及干预在交付顺序上采用结构化但灵活的方法以满足个体需求。参与者的体验支持了ACTion mTBI的可接受性、文化和精神责任。建议的改进包括使人们能够在一段时间内获得干预，而不仅仅是在康复过程中的某一个时间点，以及增加一次简短的跟进检查。
