Factors Associated with Response to Adapted Cognitive Behavioral Therapy for Anxiety and Depression following Traumatic Brain Injury

Jennie Ponsford, Nicole K. Lee, Dana Wong, Adam McKay, Kerrie Haines, Marina Downing, Yvette Alway, Christina Furtado, Meaghan L. O'Donnell

Research output: Contribution to journalArticleResearchpeer-review

12 Citations (Scopus)


Background: Given the high frequency and significance of anxiety and depression following traumatic brain injury (TBI), there is a need to evaluate the efficacy of psychological interventions and to understand factors influencing response to such interventions. The present study investigated factors associated with positive response to cognitive behavioral therapy adapted for cognitive impairments (CBT-ABI) for individuals with anxiety and depression following TBI, including demographic and injury-related factors, pretreatment levels of anxiety and depression, working alliance, and change expectancy as predictors. Methods: Participants were 45 individuals enrolled in an active treatment condition within a randomized controlled trial, examining the efficacy of a 9-session CBT-ABI program for anxiety and depression following TBI. These participants completed all CBT sessions. Results: Mixed-effects regressions controlling for baseline anxiety and depression indicated that for anxiety, older age at injury, as well as higher level of baseline anxiety, was associated with greater symptom reduction. For depression, longer time since injury and higher expectancy for change, as well as higher baseline level of depression, were significantly associated with a greater reduction in depression symptoms. Conclusions: This study paves the way for more detailed studies of the therapeutic processes involved in alleviating anxiety and depression following TBI.

Original languageEnglish
Pages (from-to)117-126
Number of pages10
JournalThe Journal of Head Trauma Rehabilitation
Issue number2
Publication statusPublished - Mar 2020


  • anxiety
  • cognitive behavioral therapy
  • depression
  • traumatic brain injury

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