The effectiveness of a family-centred intervention after traumatic brain injury: A pragmatic randomised controlled trial.
Mari S Rasmussen, Nada Andelic, Are H Pripp and 2 others
PMID 33858221WHAT IT FOUND
Adding an eight-session family intervention to standard outpatient rehabilitation did not improve mental health quality of life, caregiver burden, or family functioning compared to standard care alone.
Both groups improved over time, but the family sessions provided no extra benefit.
Key findings
01There were no significant between-group differences on the primary outcomes of mental health-related quality of life and caregiver burden at follow-up.
02The intervention group showed significant within-group improvements in family functioning, communication, and satisfaction during the treatment period, which the control group did not.
03Patients in the control group had a significant improvement in condition-specific quality of life from start-of-treatment to two-month follow-up, whereas the intervention group did not.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Most patients had mild traumatic brain injury, so results may not generalise to severe cases. The control group received a psychoeducational session, which may have diluted the difference between groups. Families were recruited from a single specialised clinic and the intervention was delivered by the same therapist, limiting generalisability. Participants had relatively balanced family functioning at baseline, meaning those with the most severe dysfunction may not have participated or benefited. The study was pragmatic, with some sessions combined or tailored, which may have reduced the intervention's intensity.
Declared interests
The authors declared no conflicts of interest. The study was funded by the DAM Foundation (Stiftelsen Dam), which had no role in design, analysis, or writing.
The easy way to misread this
Do not conclude that family interventions are ineffective. The study compared a high-intensity family intervention against a control group that also received specialised rehabilitation and psychoeducation. The lack of difference suggests the added benefit of the specific eight-session model was minimal over and above standard care, not that family support is useless.