Do Treatment Ingredients Targeting Working Alliance Improve Cognitive Rehabilitation Session Performance in Patients...

Area of Science:

• Neuroscience
• Clinical Psychology
• Rehabilitation Science

Background:

• Cognitive deficits following acquired brain injury (ABI) often impair daily functioning.
• Patient engagement and therapeutic alliance are crucial for effective cognitive rehabilitation.
• Limited experimental data exists on specific clinician behaviors that enhance the working alliance in this context.

Purpose of the Study:

• To experimentally evaluate the impact of clinician-introduced therapy ingredients on the working alliance (WA) and patient engagement.
• To determine if enhancing the WA improves performance in attention tasks, learning new skills (phone application), and adherence to home exercises.
• To assess patient perceptions of the working alliance.

Main Methods:

• Employed a concurrent multiple-baseline design with randomization.
• Included four adult participants with chronic cognitive deficits post-ABI.
• Utilized visual and quantitative analyses to compare outcomes with and without alliance-enhancing interventions.

Main Results:

• A strong positive effect was observed on attention span task performance.
• Participants demonstrated improved learning of a phone application.
• Homework adherence was maintained or improved during the intervention phase.
• Patient perceptions of the working alliance yielded mixed results.

Conclusions:

• Provides initial experimental evidence that alliance-enhancing interventions positively influence patient performance in cognitive rehabilitation.
• Suggests that specific clinician behaviors can significantly impact patient outcomes.
• Recommends further research to build upon these findings in cognitive rehabilitation settings.