Cognitive and psychological flexibility after a traumatic brain injury and the implications for treatment in acceptance-based therapies: A conceptual review |
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Authors: | Diane L Whiting Frank P Deane Grahame K Simpson Hamish J McLeod Joseph Ciarrochi |
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Institution: | 1. Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Liverpool, Australia;2. School of Psychology, University of Wollongong, Wollongong, Australia;3. Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Liverpool, Australia;4. School of Psychology, University of Wollongong, Wollongong, Australia;5. John Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, Australia;6. Institute of Health and Well-being, University of Glasgow, Glasgow, Scotland;7. Institute of Positive Psychology &8. Education, Australian Catholic University, Strathfield, Australia |
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Abstract: | This paper provides a selective review of cognitive and psychological flexibility in the context of treatment for psychological distress after traumatic brain injury, with a focus on acceptance-based therapies. Cognitive flexibility is a component of executive function that is referred to mostly in the context of neuropsychological research and practice. Psychological flexibility, from a clinical psychology perspective, is linked to health and well-being and is an identified treatment outcome for therapies such as acceptance and commitment therapy (ACT). There are a number of overlaps between the constructs. They both manifest in the ability to change behaviour (either a thought or an action) in response to environmental change, with similarities in neural substrate and mental processes. Impairments in both show a strong association with psychopathology. People with a traumatic brain injury (TBI) often suffer impairments in their cognitive flexibility as a result of damage to areas controlling executive processes but have a positive response to therapies that promote psychological flexibility. Overall, psychological flexibility appears a more overarching construct and cognitive flexibility may be a subcomponent of it but not necessarily a pre-requisite. Further research into therapies which claim to improve psychological flexibility, such as ACT, needs to be undertaken in TBI populations in order to clarify its utility in this group. |
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Keywords: | Psychological flexibility Cognitive flexibility Acceptance and commitment therapy (ACT) Traumatic brain injury Conceptual review |
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