A scoping review of therapies to support marriages and partnerships after acquired brain injury.

BACKGROUND: Acquired brain injury (ABI) can undermine marriages/partnerships. Couples need access to relationship therapies proven to be effective in a brain injury context. OBJECTIVE: To provide an overview of relationship therapies evaluated for use in ABI. METHODS: Six databases were searched for studies that evaluated the impact on the relationship of interventions that were, at least partly, intended to improve the relationship. RESULTS: Twenty-seven papers were included. Some reported the use of therapies widely used with other populations (family therapy, emotion-focused therapy, behavioral couples therapy). Others involved a structured curriculum specifically designed for use with couples living with ABI and focused on education and skills training. Most therapies also addressed non-relational issues. Couples tended to be middle-aged, White, and heterosexual. Studies generally used weak designs, and there were only six randomized controlled trials. Of 24 outcomes reported by these RCTs, all but three were classed as showing no effect or small improvement. CONCLUSIONS: Therapies would benefit from further development to ensure better outcomes, in part by ensuring that sufficient therapeutic time is allocated and that all the relational issues of concern to the couple are addressed. More inclusive samples and stronger designs would also help.