Teletherapeutic Intervention to Change Affect Recognition and Empathy after Brain Injury: A Feasibility Study

Research Objectives: To explore the preliminary feasibility of a new teletherapy program, Intervention to Change Affect Recognition and Empathy (ICARE), for individuals with traumatic brain injury (TBI).

Design: Before-after study.

Setting: Community.

Participants: Eight adults with mild to severe TBI and their care-partner (CP). Participants with TBI had to have self- or CP-reported problems with reading and/ or responding to others’ emotions.

Interventions: ICARE is a 12-session teletherapeutic intervention that teaches Affect Recognition (AR) and Empathy skills. It is delivered remotely by a staff person via secured Zoom. The CP is involved in two to three of the empathy training sessions.

Main Outcome Measures: Study completion; adverse events (AE), satisfaction; AR (DANVA-Adult Faces and the Advanced Clinical Solutions Facial Affect Naming subscale); and the St. Andrew’s Swansea Neurobehavioral Outcome Scale (SASNOS) Interpersonal Behavior (IB) Domain Total and subscales (Social Interaction; Relationships), which were self- and CP-rated. For CPs, data was also collected on the CareQOL Emotional Suppression and Anxiety measures. Relationship quality (RQ) was also evaluated.

Results: Seven dyads completed the study (88%) with no study-related AEs. Total AR scores improved by a mean of 4.57 (SD=2.15). The SASNOS IB, Social Interaction, and Relationships scales (scales with a 10-point SD) showed mean changes of 1.61, 5.70, and 1.29, respectively for self-ratings, and 4.36, 7.80, and 1.96 for CP ratings. CP Emotional Suppression and Anxiety (scales with a 10-point SD) reduced by an average of 5.27 and 1.83 points, respectively. As perceived by participants with TBI, RQ with their CP improved (pre-test mean= 6.57; posttest mean=8.29) on a scale from 1-10. CP’s perception of RQ started high with negligible post-treatment changes (pre-test mean= 8.14; posttest mean=8.86). For satisfaction, 100% agreed they were satisfied with the information and would refer others; 71% agreed that they liked the teletherapy aspect.

Conclusions: ICARE is feasible and promising, particularly for improving AR and social interaction behaviors of the person with TBI, as well as reducing CP emotional suppression. More research is justified.

Author(s) Disclosures: None