MAPLES Pilot Study for Low Mood in ABI (MAPLES)
Acquired Brain Injury, Depression
About this trial
This is an interventional treatment trial for Acquired Brain Injury focused on measuring acquired brain injury, traumatic brain injury, depression, rehabilitation, executive function
Eligibility Criteria
Inclusion Criteria:
- Have a diagnosis of an acquired brain injury (e.g., traumatic brain injury, stroke)
- Speak and comprehend English
- Are a minimum of 3 months post-acquired brain injury
Are identified as having low mood. Low mood will be identified by either:
- A score of at least 7 on the depression subscale of the Hospital Anxiety and Depression Scale, indicating clinically significant levels of depression, or
- Clinicians have identified that a client has low mood (i.e., through their own administration of the HADS within the past 3 months, through clinical interview determining that the client has low mood or would benefit emotionally from increased activity level)
Exclusion Criteria:
- Are incapable of attending to and/or understanding the intervention materials (i.e., severe cognitive disability)
- Have a diagnosis of dementia or other neurodegenerative disorder
- Unstable psychotropic medication (i.e., have recently started/recently changed medications)
- Are actively suicidal (i.e., have attempted suicide in the past 3 months, currently self-harm, and/or have a concrete plan to attempt suicide in the future, as identified by recurring clinician)
Sites / Locations
- Cambridgeshire Community Services
- Cambridge University Hospitals NHS Trust
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Experimental
Placebo Comparator
Activity Planning Group
Activity Engagement Group
Waitlist Group
Those in the Activity Planning group receive training and practice in identifying realistic and safe activities in everyday life that may be enjoyable or rewarding to complete. They gain practice in scheduling activities and identifying and overcoming barriers to completion, such as memory problems, avoidance, sticking to habitual patterns and physical and transport issues. The intervention will consist of weekly 1 hour group sessions over 8 weeks, as below: Introduction to Group Therapy Identifying Enjoyable Activities The Automatic Pilot and Planning Pleasurable Activities Goal Review and Balancing Enjoyable and Routine Activities Identifying Solutions to Goal Attainment Increasing Mastery and Managing Fatigue Active Approaches to Engagement Relapse Prevention
Individuals randomised to this arm will meet weekly for 8 weeks for 1 hour and engage in various potentially rewarding and meaningful social activities such as board games, crafting, and puzzles. Participants in this group will not receive specific training on activity scheduling or overcoming barriers to activity participation. Rather the aim is that participants gain experience of positive reinforcement from the activities and that this explicitly or implicitly challenges potentially negative predictions about such situations and encourages generalised increases in positive activity beyond the group setting. The group will cover activities such as board games, t-shirt making, puzzles, painting, "pub quizzes", figurine painting, origami/paper-craft, and clay sculptures.
In consenting to the study, individuals understand that access to groups cannot always be immediate. In the design we take advantage of this by completing the outcome measures before and after an 8-week period in participants randomized to this condition. We do not ask participants in any condition to discontinue any clinical services that they currently receive, hence the waitlist forms a treatment as usual control arm against which to judge and effects of the two groups. At the end of the waitlist the participants will be invited to take part in the Activity Planning or Activity Engagement Group depending upon their initial randomisation..