In plain language
People who survive a severe traumatic brain injury (TBI) often face a difficult psychological adjustment: distress, anxiety, depression, and unhelpful thoughts such as “my brain injury stops me doing anything.” Yet well-validated psychological treatments for this group are limited, partly because cognitive impairments after TBI can make standard talk therapies harder to deliver. This article lays out, in advance, the full plan for a randomised controlled trial testing whether Acceptance and Commitment Therapy (ACT) can help.
The trial is a single-centre, two-armed, Phase II randomised controlled trial run at the Liverpool Brain Injury Rehabilitation Unit in Sydney. Adults aged 18–65 who sustained an extremely severe TBI and report at least moderate psychological distress are randomly allocated either to a seven-session group ACT program — adapted for cognitive impairment with written session notes, repetition, and workbooks — or to an active control condition called Befriending, which provides the same amount of social contact without therapy techniques. The ACT program uses ACT’s six core processes with the aim of increasing psychological flexibility and participation in rehabilitation and reducing psychological distress, with outcomes measured at assessment, post-treatment, and follow-up.
Publishing the protocol before results are available matters for scientific transparency: it locks in the design, hypotheses, and outcome measures ahead of time, meeting the intervention-design fidelity criterion for randomised trials and the CONSORT reporting guidelines. The trial is registered on the Australian New Zealand Clinical Trials Registry (ACTRN12610000851066).
Key findings
- Reports the full protocol for a single-centre, two-armed, Phase II randomised controlled trial of ACT for psychological adjustment after severe TBI, registered as ACTRN12610000851066.
- Participants with extremely severe TBI (posttraumatic amnesia over one week) and at least moderate distress on the DASS-21 are randomised to ACT or an active Befriending control; the target sample is 48, giving over .90 power to detect a large effect.
- The ACT arm is a seven-session manualised group program built on ACT’s six core processes, adapted for cognitive impairment with written notes, repetition, workbooks, and homework monitoring.
- Three hypotheses are specified in advance: ACT will improve psychological flexibility and lower distress relative to Befriending; improved flexibility will predict lower distress; and ACT participants will show greater participation in rehabilitation.
- The primary outcome is the Acceptance and Action Questionnaire–Acquired Brain Injury (AAQ-ABI), a psychological flexibility measure developed for brain injury, alongside measures of distress and social participation at assessment, post-treatment, and follow-up.
- Publishing the protocol before trial results addresses the intervention-design fidelity criterion for RCTs and ensures transparency in line with the CONSORT statement.
How to cite
APA
Whiting, D. L., Simpson, G. K., McLeod, H. J., Deane, F. P., & Ciarrochi, J. (2012). Acceptance and Commitment Therapy (ACT) for psychological adjustment after traumatic brain injury: Reporting the protocol for a randomised controlled trial. Brain Impairment, 13(3), 360–376. https://doi.org/10.1017/BrImp.2012.28
BibTeX
@article{whiting2012acceptance,
author = {Whiting, Diane L. and Simpson, Grahame K. and McLeod, Hamish J. and Deane, Frank P. and Ciarrochi, Joseph},
title = {Acceptance and Commitment Therapy ({ACT}) for Psychological Adjustment after Traumatic Brain Injury: Reporting the Protocol for a Randomised Controlled Trial},
journal = {Brain Impairment},
year = {2012},
volume = {13},
number = {3},
pages = {360--376},
doi = {10.1017/BrImp.2012.28}
}
Related work
- All publications by Joseph Ciarrochi (searchable, with free PDFs)
- Process-Based Therapy & Idionomic Analysis
Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.