Adding dialectical behaviour therapy to multidisciplinary rehabilitation does not change quality of life but can improve emotional regulation and personal goals attainment after acquired brain injury.

Abstract

To compare changes in quality of life (primary outcome), emotional dysregulation, personal goal attainment, self-esteem, and symptoms of depression, anxiety, and stress between a 5-month control phase of multidisciplinary intervention without Dialectical Behaviour Therapy (DBT) and a 5-month phase with DBT, and a follow-up phase, in patients at a chronic phase of acquired brain injury (ABI). Monocentric, open, comparative, prospective trial with three 5-month phases, where 44 participants, aged 19 to 65, with chronic ABI and emotional dysregulation served as their own controls. After 5 months of DBT, self-reported emotional regulation difficulties (DERS-16) decreased more in the DBT phase than in the control phase, and these results were maintained at follow-up. Improvements in quality of life (QOLIBRI) were similar in both phases. There were no improvements in self-esteem (RSE) or symptoms of stress, anxiety, and depression (DASS-21). Despite the persistence of high levels of stress, anxiety, and depression post-therapy, 75% of participants maintained achievement of personal goals at follow-up. DBT can be useful for improving emotional regulation after ABI and can improve goal attainment even in the presence oh high distress.