title: Interventions to increase engagement with rehabilitation in adults with acquired brain injury: A systematic review.
abstract: Rehabilitation in adults with acquired brain injury is often hampered by a lack of client engagement with the rehabilitation process, leading to frustration, withdrawal of services and poorer recovery. Motivation, apathy and awareness are potential mechanisms underlying engagement, but few studies have suggested potential intervention techniques. A systematic review of the literature was carried out to identify and evaluate interventions designed to increase rehabilitation engagement in adults with acquired brain injury. Database searches used the following terms: rehabilitation, brain injury, and compliance/engagement/adherence in PsychInfo, Medline, Cinahl, Embase, AMED, Web of Knowledge, PsycBite, Cochrane clinical trials, and clinicaltrials.org. Hand searches were conducted of reference lists and relevant journals. Fifteen studies were included in the review. Intervention techniques fell into two broad categories: behavioural modification techniques and cognitive/meta-cognitive skills. Contingent reward techniques were most effective at increasing adherence and compliance, while interventions enabling clients' active participation in rehabilitation appeared to increase engagement and motivation. The review highlighted methodological and measurement inconsistencies in the field and suggested that interventions should be tailored to clients' abilities and circumstances.
authors.affiliation: a Department of Psychology , University of Edinburgh , Edinburgh , UK.|b Department of Psychology , City University London , London , UK.
authors.forename: Caroline Elizabeth
authors.initials: CE
authors.lastname: Brett
authors.affiliation: c Private Practice, St Paul's Practice , London , UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Sykes
authors.affiliation: b Department of Psychology , City University London , London , UK.|d South London and the Maudsley NHS Trust, Liaison Psychiatry for Guy's and St Thomas's Hospital , London , UK.
authors.forename: Renata
authors.initials: R
authors.lastname: Pires-Yfantouda
mesh_terms: D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D006297:Health Services Accessibility; D006801:Humans; D000066530:Neurological Rehabilitation / Q000379:methods*
keywords: Acquired brain injury; Engagement; Motivation; Rehabilitation