Development and refinement of an online group-based clinical neuropsychology rehabilitation programme to improve psychological wellbeing and quality of life after acquired brain injury.

Context: Acquired brain injury (ABI) is a type of brain injury caused by medical conditions (e.g., stroke) or injuries (e.g., traffic accidents). In the UK, 1.4 million people live with the consequences of ABI, which can be life-long, costing the economy £15 billion annually (10% of the NHS annual budget). Approximately 20% of ABI survivors experience emotional and/or thinking skills problems. These problems can impact people's return to hobbies and work, and increases risk of isolation, resulting in psychological distress and reduced quality of life. The problem: Neuropsychological rehabilitation (a type of psychological therapy) is useful in treating such problems, but is typically delivered face-to-face in individual or group sessions. However, due to a lack of NHS resources, not all ABI survivors get the help they need. Furthermore, limited clinic space and COVID-19 restrictions mean group sessions cannot always be provided safely, if at all. Our solution: Online group-based neuropsychological rehabilitation may provide an alternative, that can fit around busy lives (e.g., for ABI survivors who work), group people according to shared experiences (e.g., young survivors), or overcome issues of physical contact (e.g., those with mobility problems). Despite possible advantages, such ABI-specific neuropsychological rehabilitation has not been systematically developed or evaluated. Our aim To develop an online, group-based neuropsychological rehabilitation programme to improve psychological wellbeing for ABI survivors, and to test whether patients find it useful and acceptable, and the NHS can deliver it. Methods To develop the programme (or "intervention"), we will: 1. Review previous research to understand how neuropsychological therapies are delivered, by whom, in which contexts, and who benefits. This will enable us to produce an initial plan/blueprint for the new intervention. 2. Develop this plan/blueprint further, to produce an intervention manual, by: (i) surveying ABI survivors and stakeholders to explore different views regarding group-based online interventions (ii) seeking feedback from an advisory group of professional and patient experts (iii) conducting interviews with ABI survivors and stakeholders to critique and refine the intervention. 3. To test the intervention, we will deliver it to two groups of approximately 4-6 patients each. We will seek feedback on acceptability and feasibility of delivering the intervention from ABI survivors and therapists, enabling further modifications of our intervention. Patient and Public Involvement (PPI) PPI underpins our project design and delivery. The idea originated from our clinical work and patient feedback, and this project was co-designed by our PPI Lead. We have listened to feedback from our ABI survivors and carers' PPI group, who think it is vital they get neuropsychological therapies targeting psychological wellbeing, and are keen to explore online options. Dissemination Results of each stage will be communicated to participants (via accessible newsletters), published in scientific journals and presented at conferences.