A scoping review of therapies to support marriages and partnerships after acquired brain injury

Strong marriages/partnerships are a major asset in dealing with acquired brain injury, and rehabilitation services should help couples sustain a strong relationship when requested. The aim of this review was to summarise what therapies have been used and evidence for their use. Six databases were searched for studies reporting on the use of relationship therapies, and 28 studies were included in the review. Some studies reported on the use of therapies widely used with other populations (family therapy, emotion-focused therapy, behavioural couple therapy). Other therapies involved a highly structured curriculum specifically designed for use with brain injury couples. These consisted largely of cognitive-behavioural techniques such as education, skills training, and goal setting. The quality of study design was generally poor and there were only seven RCTs. Outcomes were disappointing. Out of 28 outcomes reported by the RCTs, all but three showed either no effect or small improvement. Therapy in this context needs further development. Coverage of relational issues needs to be more comprehensive, and, in the case of the structured therapies, more therapy time needs to be devoted to the relationship itself. The relative advantages and disadvantages of the structured therapies vs. the therapies in general use are discussed.