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Window to Hope: A Randomized Controlled Trial of a Psychological Intervention for the Treatment of Hopelessness Among
Lisa A Brenner1, Jeri E Forster, Adam S Hoffberg
1VA Rocky Mountain Mental Illness Research, Education and Clinical Center, Denver, Colorado (Drs Brenner, Forster, Matarazzo, and Signoracci, Mr Hoffberg, and Ms Hostetter); Department of Physical Medicine and Rehabilitation (Drs Brenner, Forster, and Signoracci), Department of Psychiatry (Drs Brenner, Matarazzo, and Signoracci), and Department of Neurology (Dr Brenner), University of Colorado Anschutz Medical Campus, Aurora, Colorado; and Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, and John Walsh Centre for Rehabilitation Research, Kolling Institute, University of Sydney New South Wales, Australia (Dr Simpson).
Objective:
To evaluate the efficacy of a psychological intervention to reduce moderate to severe hopelessness among Veterans with moderate to severe traumatic brain injury (TBI).
Design:
Two-arm parallel group, controlled, randomized crossover trial, with 3-month follow-up for those initially allocated to treatment. Participants were randomly allocated in blocks of 4 on a 1:1 ratio to treatment (n = 15) or waitlist (n = 20) groups.
Setting:
A Veterans Affairs Medical Center.
Participants:
Veterans between the ages of 26 and 65 years, with a history of moderate to severe TBI, and moderate to severe hopelessness.
Interventions:
A 20-hour manualized small group cognitive-behavioral intervention.
Main Outcome Measures:
Beck Hopelessness Scale (primary), Beck Depression Inventory, and Beck Scale for Suicide Ideation.
Results:
A significant difference between groups was found for postintervention scores on the Beck Hopelessness Scale (P = .03). Significant decreases were maintained at follow-up. For those initially allocated to the waitlist group who completed the intervention, treatment gains were noted in decreased hopelessness (P = .01) and depression (P = .003).
Conclusions:
Findings from this trial provide additional support for the efficacy of this method of psychological treatment of hopelessness among individuals with moderate to severe TBI.
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