Examining the effectiveness of a cognitive stimulation therapy intervention for adults with an acquired brain injury: a mixed methods study

Background: My systematic review of studies addressing research recommendations of a clinical practice guideline completed within this study was used to define the most effective factors that constitute a successful intervention in current brain injury literature. Cognitive stimulation therapy (CST) was deemed to be a close fit to these intervention recommendations. Based on this, it was postulated that CST would be a useful intervention to evaluate based on a current need for more streamlined, effective interventions across ABI rehabilitation services in a national and international context. Method: This research utilised a mixed methods approach to evaluate change in neuropsychological functioning, mental health and adjustment in the intervention group compared to a treatment as usual (TAU) group (quantitative phase). The qualitative phase explored participants’ experience of the intervention through focus groups. Quantitative data (N = 65) were analysed using a 2x2 repeated measures ANCOVA. Thematic Analysis (TA) was used to examine the qualitative findings in greater depth (N = 16). Results: Quantitative analysis indicated there was no significant difference in outcomes between two groups receiving two different rehabilitation approaches (CST vs. TAU). There was a statistically significant change over time (pre/post) for the intervention group on RBANS Visuospatial and Delayed Memory indices. Clinically significant change was observed for the RBANS Attention index and Total Scale score for the intervention group. Three qualitative themes were extracted from the data. Theme One: Differences in Personal Learning; Theme Two: Benefits and Limitations of a Group Intervention and Theme Three: Thinking Ahead. Quantitative findings were mapped onto qualitative themes to synthesise findings. Conclusions: There was no statistically significant difference in outcomes between groups in receipt of two different rehabilitation approaches (CST vs TAU). However, this study provides some preliminary evidence that a CST intervention had positive effects on adults with an ABI. It is suggested that the intervention proved engaging, meaningful and enjoyable for participants which may have aided in focusing attention. Improved attention may have subsequently underpinned cognitive improvements on visuospatial and delayed recall ability.