Psychotherapeutic Intervention for Adults With Acquired Brain Injury: A Case Study Using BackUp

A moderate-to-severe acquired brain injury (ABI) can have tremendous lifelong consequences for ABI-survivors and their families. Despite rehabilitation practice since the 1980s aspiring to a dynamic, coherent and holistic approach, the psychological dimension still seems to be a challenge and research has revealed persisting psychosocial impairments after ABI. Therefore, we developed BackUp©, a manual based short term psychological intervention for adults with ABI. This study explores the effect of the intervention though a small feasibility study, employing a single case design. One client received the intervention. Self-report measures were collected, and a semi structured interview was conducted. While results from pre, post and follow-up measures do not show clear positive results, the interview reveals positive experiences and the participant reported achieving his therapy goal. This case study provides support for a psychological intervention to support the psychological rehabilitation after an ABI.

Interpersonal Psychotherapy and Mindfulness for Treatment of Major Depression With Anxious Distress

This single case study examined symptom change in the treatment of a 22-year-old Caucasian female college student presenting with anxious and depressive symptoms and maladaptive coping strategies in the context of an interpersonal dispute. The treatment integrated mindfulness skills training with interpersonal psychotherapy (IPT) to treat symptoms of anxiety, depression, overall total symptoms, and relational problems across the 18-session treatment. We assessed symptoms across treatment and analyzed change in symptom severity over time. Reliable change index analyses indicated significant symptom reduction between baseline levels at the start of treatment and the final sessions in all measured symptoms (anxiety, depression, total symptoms, and interpersonal relations), with decreases in symptom severity occurring gradually over the course of treatment. A 1-month follow-up assessment of symptoms indicated sustained reductions in anxious and depressive symptoms since baseline measurements. We discuss recommendations on the importance of therapeutic flexibility in treating comorbid conditions and therapist willingness to combine multiple treatment approaches for better treatment outcomes.

Dialectical Behavior Therapy Skills Training for Persistent Complex Bereavement Disorder

Although the majority recovers from the death of a loved one, nearly 5% exhibit persistent symptoms of grief, known as Persistent Complex Bereavement Disorder (PCBD). PCBD has adverse health, social, and psychological consequences. We examined the effectiveness of dialectical behavior therapy (DBT) skills training with a 57-year-old African American woman who met the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) criteria for PCBD and Persistent Depressive Disorder. The client met with a graduate student therapist (i.e., the second author) who applied DBT skills training on an individual basis. By the end of treatment, the participant no longer met the criteria for either of these disorders. Reliable and clinically significant reduction in her grief and depressive symptoms, suicidality, and sleep difficulties were noted from pre- to posttreatment and maintained for 2 months post treatment. Furthermore, she improved her ability to regulate her emotions and cognitions using DBT coping skills and eliminated substance abuse. These results prompt the need for more research to further investigate DBT skills training for PCBD.

Therapeutic Assessment With a Client With Persistent Complex Bereavement Disorder: A Single-Case Time-Series Design

This article presents the results of a study into the effectiveness of therapeutic assessment (TA), a brief form of intervention that incorporates the results of assessment findings into psychological treatment. The history of Anthony, a man who reported symptoms of persistent complex bereavement disorder (PCBD), associated with major depression disorder (MDD) and post-traumatic stress disorder (PTSD), is presented. After his parents’ deaths, Anthony became detached from reality, lost all pleasure in his everyday life, and found it impossible to overcome the devastating feelings related to the loss. Following TA principles, the assessor created a supportive and empathic relationship with Anthony and helped him attain his goals for the assessment. The assessment was monitored using a single-case quasi-experimental design with time-series analysis. Results of this study revealed a specific trajectory of Anthony’s self-reported symptoms and a statistically significant trend toward improvement in severity at the end of the TA. This case study highlights the utility and efficacy of TA in helping clients process traumatic losses and complicated bereavements.