Research Reports - Group therapy use and its impact on the outcomes of inpatient rehabilitation after traumatic brain injury
Arch Phys Med Rehabil. 2015 Aug;96(8 Suppl):S282-S292.e5. doi:
Hammond FM(1), Barrett R(2), Dijkers MP(3), Zanca JM(4), Horn SD(2), Smout RJ(2),
Guerrier T(5), Hauser E(5), Dunning MR(6).
OBJECTIVES: To describe the amount and content of group therapies provided during
inpatient rehabilitation for traumatic brain injury (TBI), and to assess the
relations of group therapy with patient, injury, and treatment factors and
DESIGN: Prospective observational cohort.
SETTING: Inpatient rehabilitation.
PARTICIPANTS: Consecutive admissions (N=2130) for initial TBI rehabilitation at
10 inpatient rehabilitation facilities (9 in the United States, 1 in Canada) from
October 2008 to September 2011.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Proportion of sessions that were group therapy (≥2
patients were treated simultaneously by ≥1 clinician); proportion of patients
receiving group therapy; type of activity performed and amount of time spent in
group therapy, by discipline; rehabilitation length of stay; discharge location;
and FIM cognitive and motor scores at discharge.
RESULTS: Of the patients, 79% received at least 1 session of group therapy, with
group therapy accounting for 13.7% of all therapy sessions and 15.8% of therapy
hours. On average, patients spent 2.9h/wk in group therapy. The greatest
proportion of treatment time in group format was in therapeutic recreation
(25.6%), followed by speech therapy (16.2%), occupational therapy (10.4%),
psychology (8.1%), and physical therapy (7.9%). Group therapy time and type of
treatment activities varied among admission FIM cognitive subgroups and treatment
sites. Several factors appear to be predictive of receiving group therapy, with
the treatment site being a major influence. However, group therapy as a whole
offered little explanation of differences in the outcomes studied.
CONCLUSIONS: Group therapy is commonly used in TBI rehabilitation, to varying
degrees among disciplines, sites, and cognitive impairment subgroups. Various
therapeutic activities take place in group therapy, indicating its perceived
value in addressing many domains of functioning. Variation in outcomes is not
explained well by overall percentage of therapy time delivered in groups.