Adapting Groups 4 Health for adults with acquired brain injury: A case series feasibility study

This study aimed to adapt and evaluate the feasibility, acceptability, mechanisms of change, and preliminary outcomes of Groups 4 Health, a social identity-informed group intervention, for individuals with acquired brain injury in an outpatient rehabilitation setting. The adaptation process involved three phases: modification for cognitive and language impairments, expert consultation, and in vivo consumer feedback. Five participants completed the five-session intervention with no dropouts and high adherence, demonstrating strong feasibility. Quantitative data were analysed descriptively, and qualitative data were explored using reflexive thematic analysis. Acceptability ratings were uniformly high, with participants rating the programme as relevant, enjoyable, and useful. Post-program interviews highlighted key engagement facilitators including accessible content, skilled facilitation, and meaningful peer connection. Participation was a catalyst for social re-engagement and increased confidence. Ratings of theorized mechanisms showed consistently high group identification, though findings for multiple group membership were mixed. No significant changes in psychological distress or loneliness were observed, likely due to the small sample and external factors (e.g., COVID-19). Participants recommended extending the programme to support deeper connection-building and skill consolidation. These findings support the programme's potential and inform future proof-of-concept research with larger samples, longer follow-up, broader outcome measurement, and exploration of mechanisms and moderating factors.