The Role of Hope in those Recovering from an Acquired Brain Injury: Are Shame, Adaptive Guilt, Psychological Flexibility, Perceived Responsibility for Injury, and Injury Severity Predictors?

The first paper is a literature review investigating the existing evidence base for the use of Compassion Focussed Therapy (CFT) for people who have had an Acquired Brain Injury (ABI). An ABI is an injury to the brain after birth but not related to degenerative conditions. A review of the literature was completed, and nine studies were included. The results suggest that CFT after an ABI leads to an increase in self-reassurance, self-esteem, and self-compassion. It also leads to reductions in anger, avoidance, emotional distress, self-hatred, self-criticism, depression, and anxiety. Limitations of the studies included small sample sizes and problems with validity and treatment fidelity. Clinical implications are discussed, including making adaptations to therapy. Paper two describes a quantitative study investigating the ability to predict hope after an ABI by using the variables of shame, adaptive guilt, perceived responsibility for the injury, injury severity and psychological flexibility. A total of 90 participants with an ABI were recruited to take part in the study. Multiple regression analyses were completed. The results suggest that lower levels of shame and injury severity and higher levels of adaptive guilt were significant predictors of higher levels of hope. Psychological flexibility and perceived responsibility for injury were not significant predictors of levels of hope. The findings suggest that it might be helpful to reduce levels of shame in order to increase hopefulness after an ABI, possibly by using CFT. Implications for clinical practice and recommendations for future research are provided. Paper three is an executive summary of the results. It has been developed with the use of feedback from service users and designed to be shared with people with an ABI and others that may be interested in the study.