Effectiveness of a group anger management programme after severe traumatic brain injury.

PRIMARY OBJECTIVE: This study examined the effectiveness of a group approach to the treatment of anger management difficulties for people with severe traumatic brain injury (TBI). RESEARCH DESIGN: Repeated-measures design with convenience sampling. METHOD AND PROCEDURE: Participants were community living clients of a tertiary brain injury service. The group programme consisted of 12 weekly sessions based on a cognitive behavioural therapy (CBT) model, with modifications to incorporate compensations for TBI-related cognitive impairment. Treatment effectiveness was measured using the State-Trait Anger Expression Inventory (STAXI), at pre-treatment, post-treatment and follow-up. MAIN OUTCOMES AND RESULTS: The programme was completed by 52 people across nine groups over the years 1998-2006 and 31 of these attended a follow-up session. Completion of the programme was associated with significant decreases in self-reported frequency with which anger was experienced (STAXI Trait Anger) and frequency of expression of anger (Anger Expression-Out), as well as a significant increase in reported attempts to control feelings of anger (Anger Control); changes were maintained at follow-up assessment. CONCLUSIONS: A group CBT approach shows promise as an effective community-based treatment for anger control issues after severe TBI. Future research directions should include a wait-list control group and objective rating of anger expression.

Cognitive rehabilitation after severe traumatic brain injury: a pilot programme of goal planning and outdoor adventure course participation.

PRIMARY OBJECTIVE: To describe and evaluate a pilot community based rehabilitation programme for severe brain injury. RESEARCH DESIGN: A prospective repeated-measures design with a single convenience sample was conducted. METHODS AND PROCEDURES: Eleven participants with a history of severe brain injury completed the programme, which featured an outdoor adventure course, skill development and goal-based learning. In the first stage, practical activities facilitated the development of social skills, group cohesiveness and community integration. The second stage was a 9-day outdoor adventure course, which included physically challenging activities such as camping, bushwalking, abseiling, caving and high rope work. The third stage encouraged individuals to work on the personal goals they had developed. MAIN OUTCOMES AND RESULTS: Over 80% of stated goals were achieved; suggesting that such a programme may be effective in enabling clients to attain specified goals. CONCLUSIONS: The programme shows promise as a form of community rehabilitation.