Can a Couples' Intervention Reduce Unmet Needs and Caregiver Burden After Brain Injury?

• Published in: Rehabilitation psychology 2020-11, Vol.65 (4), p.409-417
• Main Authors: Graham, Kristin M., Kreutzer, Jeffrey S., Marwitz, Jennifer H., Sima, Adam P., Hsu, Nancy H.
• Format: Article
• Language: English
• Subjects: Brain Injuries; Caregiver Burden; Caregivers; Couples Therapy; Family; Female; Human; Intervention; Intimacy; Male; Needs; Parents
• ISSN: 0090-5550; 1939-1544
• DOI: 10.1037/rep0000300

Objective: To examine the effectiveness of the Therapeutic Couples Intervention (TCI) on caregiver needs and burden after brain injury. Research Method: Individuals with brain injury and their intimate partners/caregivers (n = 75) participated in a 2-arm, parallel, randomized trial with a waitlist control. The TCI consisted of 5 2-hr sessions, with a sixth optional session for parents. The Family Needs Questionnaire-R (FNQ-R) and the Zarit Burden Interview (ZBI) were secondary outcome measures. Results: After adjusting for baseline characteristics, caregivers in the TCI group demonstrated reduction in unmet needs for 5 of the 6 FNQ-R subscales, whereas those in the waitlist control group did not. ZBI scores improved significantly for TCI caregivers but not for controls. At the 3-month follow-up, benefits were maintained for the ZBI and 4 of the 6 FNQ-R subscales (Health Information, Emotional Support, Professional Support, and Community Support Network). Conclusions: The present investigation provided evidence that, following brain injury, a structured couples intervention can reduce unmet needs and burden in caregivers. Future multicenter research examining long-term durability of treatment gains and specific characteristics of positive responders is warranted. Impact and Implications A structured couples intervention designed to improve relationship quality following acquired brain injury had the added benefit of reducing burden and unmet needs unique to the uninjured partner. Guidance is provided to therapists working with couples following acquired brain injury, such as traumatic brain injury, stroke, and other nonprogressive neurological disorders. Clinicians are offered an empirically validated tool that enables them to improve caregivers' well-being and partner relationships after brain injury.