Changes in stress and burden in families seeking therapy following traumatic brain injury Academic Article uri icon


  • The current project is a preliminary investigation of changes in levels of distress and burden and family and marital adjustment in families following traumatic brain injury (TBI), replicating measures-used in the earlier Glasgow, TBI outcome research on relatives' stress and burden. Fifteen families (32 individuals) seeking family counselling in a publicly funded family therapy centre were monitored over a two year period: prior to commencing counselling; 12 months following the commencement of counselling; and 24 months following the commencement of counselling. The most significant and sustained changes in psychosocial outcome were a decrease in distress for both individuals with TBI and their carers as well as a reduction in relatives' burden and strain. Family conflict also reduced, just as family cohesion increased and adjustment within the family unit improved from pre-therapy to the time of follow-up 24 months later. However, reported levels of anger, despite significantly reducing during the first 12 months of the study, actually increased back to their original levels at the 24 month follow-up. Marital adjustment also worsened in the latter half of the study, with couples reporting a similar level of marital adjustment to that which they had experienced prior to counselling. These findings are discussed and recommendations made for more rigorous, controlled, longitudinal studies of the effectiveness of family therapy. It was also recommended that marital couples receive longer-term counselling to address their specific needs, and that the issue of anger be further investigated with a view to either reducing family members' anger, or bearing witness to the legitimacy of their anger in the longer-term, and assisting with anger-management programmes.

publication date

  • December 1998