Cognitive behaviour therapy to treat sexual problems after traumatic brain injury (TBI): A pilot single case series

Sexuality is one of the primary human functions that can be affected after moderate to severe TBI. Previous studies have demonstrated that 36%–54% of adults with moderate to severe TBI report problems in sexual functioning. Problems range from a reduction in perceived importance of sexuality, to lower sex drive and arousal maintenance, reduced frequency of intercourse, and a decreased ability to experience orgasm and provide sexual satisfaction to partners. These problems do not diminish over time. Factors contributing to these changes include depression and anxiety, low self-esteem, fatigue, social participation difficulties, reduced independence in activities of daily living, and altered marital and family roles.

Given the complex and multi-factorial aetiology of sexual changes after TBI, interventions need to be holistic, long term and individualised to each survivor. Currently, there is limited empirical evidence to support the efficacy of rehabilitative techniques for sexual problems in TBI populations, with only one case study to date8. The purpose of the proposed research is to develop a manualised intervention and pilot it in a series of single case studies to test the efficacy of cognitive behavioural therapy (CBT) adapted for individuals with complicated mild to severe TBI in improving sexual wellbeing.