Outcome Study of Hold Me Tight Program With Acquired Brian Injury (ABI) Populations

• Dyadic Adjustment Scale (DAS) [ Time Frame: Change from Baseline in DAS scores at the end of the intervention and at three month follow-up ] [ Designated as safety issue: No ]
  
• Beck Depression Inventory (BDI) [ Time Frame: Change from Baseline in BDI scores at the end of the intervention and at three month follow-up ] [ Designated as safety issue: No ]
  
• Beck Anxiety Inventory (BAI) [ Time Frame: Change from Baseline in BAI scores at the end of the intervention and at three month follow-up ] [ Designated as safety issue: No ]
  

• Hold Me Tight Conversations Rating Scale [ Time Frame: 12 weeks and three month follow-up ] [ Designated as safety issue: No ]
  
• Hold Me Tight Program Evaluation [ Time Frame: 12 weeks ] [ Designated as safety issue: No ]
  

Families, and spouses in particular, have been shown to play important roles in all aspects of health care, especially when family members are recovering from the trauma of sudden illness or an accident such as a brain injury. A limited body of evidence suggests couple therapy provides patients and their spouses with the opportunity to explore the experience of trauma as it relates to becoming physically disabled within the context of intimate relationships. Being in close contact and emotionally connected to a person who has experienced trauma becomes a chronic stressor that can cause family members to experience trauma symptoms themselves. This phenomenon is termed secondary traumatic stress. For example, children can mimic a parent's trauma responses through identification with the parent or direct training. This is a specific type of secondary traumatisation transmitted intergenerationally.

The research about individuals who have a traumatic brain injury (TBI) and the impact of the injury on family functioning has outlined a number of challenges including: psychological distress, particularly anxiety and depression, among caregivers; disruptions in family functioning; and the impact on relationships including caregiver burden. Furthermore, among the most difficult conditions for couples to deal with are those involving cognitive impairment.

Hold Me Tight is a couples enrichment program that is based on the Emotionally Focused Therapy (EFT) approach to working with couples. EFT is an empirically supported treatment that arose out of emotion theory and attachment theory. It views emotions as centrally important in the experience of self, in both adaptive and maladaptive functioning, and in therapeutic change. From the EFT perspective change occurs by means of awareness, regulation, reflection, and transformation of emotion taking place within the context of an empathetically attuned relationship. There is significant research on this approach and it has been found that 70-75% of couples move from distress to recovery and that the gains are sustained for months to years following the end of treatment. As such, EFT is an evidence based treatment protocol.